Organization Active NPI

Neurology Clinics of Nevada LLC

  • Neurology Physician
  • Las Vegas, NV
National Provider Identifier
1487139499
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEUROLOGY CLINICS OF NEVADA LLC
Practice address
4275 Burnham Ave Ste 230
Las Vegas, NV 89119-5400
Phone
(702) 956-0996
Fax
(702) 965-2216
NPI assigned
Sep 26, 2018
Last updated
May 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Authorized official

Name
Abdul Tariq, DONPI 1669883534
Title
Physician Owner
Phone
(702) 956-0996

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

4275 Burnham Ave Ste 230
Las Vegas, NV 89119-5400

Mailing address

390 Otsego CT
Henderson, NV 89012-4862

Other practice location 1

3022 S Durango Dr Ste 100
Las Vegas, NV 89117-4440
Phone (702) 256-3637

Other practice location 2

390 Otsego Ct
Henderson, NV 89012
Phone (702) 761-4724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181213001668 NV Part B Supplier - Clinic/Group Practice 4688919053 Receives reassigned benefits from 4 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

1601 E Flamingo Rd
Ste E18
Las Vegas, NV 89119
Phone (702) 958-0996

1621 E Flamingo Rd
Las Vegas, NV 89119

621 E Flamingo Rd 16a
Las Vegas, NV 89119

621 E Flamingo Rd Ste 16a
Las Vegas, NV 89119

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1487139499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 OTSEGO CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890124862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 BURNHAM AVE STE 230",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195400",
            "telephone_number": "702-956-0996",
            "fax_number": "702-965-2216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3022 S Durango Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891174440",
            "country_code": "US",
            "telephone_number": "702-256-3637",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "390 Otsego Ct",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "89012",
            "country_code": "US",
            "telephone_number": "702-761-4724",
            "fax_number": "702-213-2863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEUROLOGY CLINICS OF NEVADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-26",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "TARIQ",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "702-956-0996",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 14, 2020; 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.

Verify at the official NPI Registry.