Active NPI
Regal Medical Group LLC
- Family Medicine Physician
- Las Vegas, NV
National Provider Identifier
1457034795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- REGAL MEDICAL GROUP LLC
- Practice address
- 1500 E Tropicana Ave Ste 164
Las Vegas, NV 89119-8314 - Phone
- (424) 205-9207
- NPI assigned
- Aug 11, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Armi Regala San Agustin
- Title
- Managing Member
- Phone
- (424) 205-9207
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
1500 E Tropicana Ave Ste 164
Las Vegas, NV 89119-8314
Mailing address
1500 E Tropicana Ave Ste 164
Las Vegas, NV 89119-8314
Phone (424) 205-9207
Other practice location 1
1500 E Tropicana Ave Ste 164
Las Vegas, NV 89119-8314
Phone (424) 205-9207
Other names 1
- N/A
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1500 E Tropicana Ave
Ste 164
Las Vegas, NV 89119
Phone (702) 659-9617
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Las Vegas, NV
- NPI 1093411548
-
- Family Nurse Practitioner
- Las Vegas, NV
- NPI 1750099099
-
- Physician Assistant
- Nellis Afb, NV
- NPI 1639319791
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691712000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1691712000000",
"number": "1457034795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 E TROPICANA AVE STE 164",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891198314",
"telephone_number": "424-205-9207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E TROPICANA AVE STE 164",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891198314",
"telephone_number": "424-205-9207"
}
],
"practiceLocations": [
{
"address_1": "1500 E Tropicana Ave Ste 164",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891198314",
"country_code": "US",
"telephone_number": "424-205-9207",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "REGAL MEDICAL GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-08-11",
"last_updated": "2023-08-11",
"certification_date": "2023-08-11",
"status": "A",
"authorized_official_last_name": "SAN AGUSTIN",
"authorized_official_first_name": "ARMI",
"authorized_official_middle_name": "REGALA",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "424-205-9207",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "N/A",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.