Individual provider Active NPI

Armen E Nikogosian, MD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1467546911
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10614 Issued in NV
Practice address
5380 S Rainbow Blvd
Suite 306
Las Vegas, NV 89118-1899
Phone
(702) 362-9930
Fax
(702) 362-9954
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 10614 NV
Internal Medicine Physician 207R00000X 10614 NV Primary

Addresses

Primary practice location

5380 S Rainbow Blvd
Suite 306
Las Vegas, NV 89118-1899

Mailing address

5380 S Rainbow Blvd
Suite 306
Las Vegas, NV 89118-1899
Phone (702) 362-9930

Other identifiers 1

IdentifierTypeStateIssuer
100500884MedicaidNV

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
I20170523001776 NV Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0749186260

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10614NVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Nikogosian LTD Specialist PastSince Sep 19, 2003 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1467546911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 S RAINBOW BLVD",
            "address_2": "SUITE 306",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181899",
            "telephone_number": "702-362-9930",
            "fax_number": "702-362-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 S RAINBOW BLVD",
            "address_2": "SUITE 306",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181899",
            "telephone_number": "702-362-9930",
            "fax_number": "702-362-9954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOGOSIAN",
        "first_name": "ARMEN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "10614",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "10614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100500884",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.