Individual provider Active NPI

Jeffery Patrick Degrauw, DO

  • Anesthesiology Physician
  • Las Vegas, NV
National Provider Identifier
1437736402
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
DO4043 Issued in NV
Practice address
7160 Rafael Rivera Way Ste 210
Las Vegas, NV 89113-5395
Phone
(702) 878-0070
Fax
(702) 805-0307
NPI assigned
Mar 25, 2021
Last updated
Apr 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X DO4043 NV Primary

Addresses

Primary practice location

7160 Rafael Rivera Way Ste 210
Las Vegas, NV 89113-5395

Mailing address

PO Box 840857
Dallas, TX 75284-0857
Phone (725) 204-4632

Other practice location 1

6431 Fannin St Ste 5.170
Houston, TX 77030-1501
Phone (713) 500-6113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210805003004 NV Order and Referring Only - AnesthesiologyPractitioner - Anesthesiology 9133523673

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12222 Merit Dr
Suite 600
Dallas, TX 75251-2276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO4043NVMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fielden Hanson Isaacs Miyada Robison Yeh LTD Anesthesiology PastSince Jun 18, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1437736402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840857",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840857",
            "telephone_number": "725-204-4632",
            "fax_number": "702-805-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7160 RAFAEL RIVERA WAY STE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891135395",
            "telephone_number": "702-878-0070",
            "fax_number": "702-805-0307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6431 Fannin St Ste 5.170",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301501",
            "country_code": "US",
            "telephone_number": "713-500-6113",
            "fax_number": "713-500-0648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEGRAUW",
        "first_name": "JEFFERY",
        "middle_name": "PATRICK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "DO4043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.