Individual provider Active NPI

Dominique Taylor, M.D.

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1487053716
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18805 Issued in NV
Practice address
540 N Nellis Blvd
Las Vegas, NV 89110-5368
Phone
(702) 877-5199
NPI assigned
Aug 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18805 NV Primary

Addresses

Primary practice location

540 N Nellis Blvd
Las Vegas, NV 89110-5368

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5199

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
I20190522002561 NV Practitioner - Internal Medicine 4880951714 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

540 N Nellis Blvd
Las Vegas, NV 89110-5368
Phone (702) 579-3253

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, Inc Internal Medicine CurrentSince Apr 22, 2019 Accepting new patients
Optum Medical Group II Rhodes P C Internal Medicine CurrentSince Jun 3, 2019 Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients
North Vista Hospital LLC Past Accepting new patients

Locations

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

4895 Boulder Hwy
Ste 101
Las Vegas, NV 89121
Phone (702) 435-1411

540 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 459-7424

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

Interoperability endpoints

  • Direct secure messaging: dtaylor119258@westdirect.optum.com

Organizations & group practices 4

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": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1487053716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 N NELLIS BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891105368",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "DOMINIQUE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-22",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "18805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.