Individual provider Active NPI

Maryam Naveed

  • Student in an Organized Health Care Education/Training Program
  • Las Vegas, NV
National Provider Identifier
1477288850
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
LL4190 Issued in NV
Practice address
1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone
(520) 694-0111
NPI assigned
Jul 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X R79323 AZ
Student in an Organized Health Care Education/Training Program 390200000X LL4190 NV Primary

Addresses

Primary practice location

1800 W Charleston Blvd
Las Vegas, NV 89102-2329

Mailing address

1701 W Charleston Blvd Ste 230
Las Vegas, NV 89102-2312
Phone (702) 671-5060

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
I20240812001776 NV Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3072051879

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R79323AZMDInfectious Disease Physician
LL4190NVMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine PastSince Jun 30, 2024 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": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1477288850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD STE 230",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022312",
            "telephone_number": "702-671-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022329",
            "telephone_number": "520-694-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVEED",
        "first_name": "MARYAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AZ",
            "license": "R79323",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NV",
            "license": "LL4190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.