Marv Alwyn Mangalino

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

11920 Southern Highlands Pkwy Ste 100
Las Vegas, NV 89141-3273

Phone

(702) 435-1995

NPI assigned

Jul 14, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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

• Ben Kermani MD LTD

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1255459285
  Medicare reassignment
• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1184795874
  Medicare reassignment
• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1043030919

  Physician Assistant

  NPD
• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1902685167
  NPD
• Ben Kermani, M.D., LTD

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1922126952
  NPD (past)

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1437838679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 BONITA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891043801",
            "telephone_number": "702-690-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11920 SOUTHERN HIGHLANDS PKWY STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891413273",
            "telephone_number": "702-435-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGALINO",
        "first_name": "MARV ALWYN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-14",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Maneth
• Douglas Patrick Manfra, D.C.
• Mary Tina Mang
• Ashley Bridget Mangahas Abad, MD
• Dolorfina Tagle Mangahas X
• Myerann Royce Manaloto Mangalino, DNP,MSN,APRN,FNP-C
• Francis Albert Mangaoang
• Ronrico Arcangel Mangapit, D.M.D., P.C.
• Khem Mangar
• Phillip Mangar, LPN

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.