NPIMap

Organization Active NPI

Sanjay Kandoth MD PC

Doing business as Sunrise Pediatrics

  • Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1487824223
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9350 Issued in NV
Legal business name
SANJAY KANDOTH MD PC
Doing business as
Sunrise Pediatrics
Practice address
3061 S Maryland Pkwy Ste 101
Las Vegas, NV 89109-6226
Phone
(702) 254-5437
Fax
(702) 254-7354
NPI assigned
Mar 7, 2008
Last updated
Aug 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Authorized official

Name
Sanjay W Kandoth, M.D.NPI 1821086190
Title
President
Phone
(702) 254-5437

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
Pediatrics Physician 208000000X 9350 NV Primary

Addresses

Primary practice location

3061 S Maryland Pkwy Ste 101
Las Vegas, NV 89109-6226

Mailing address

PO Box 60515
Las Vegas, NV 89160-0515
Phone (702) 254-5437

Other names 1

  • Sunrise Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D1077083Sunrise Pediatrics3061 S Maryland Pkwy Ste 101, Las Vegas, NV 89109Certificate of waiverNov 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Sanjay Kandoth MD PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1701 N Green Valley Pkwy
Ste 1
Henderson, NV 89074
Phone (702) 737-5500

Practitioners & affiliated clinicians

Practitioners 10

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": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376524800000",
    "number": "1487824223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60515",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891600515",
            "telephone_number": "702-254-5437",
            "fax_number": "702-254-7354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3061 S MARYLAND PKWY STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891096226",
            "telephone_number": "702-254-5437",
            "fax_number": "702-254-7354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANJAY KANDOTH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2013-08-15",
        "status": "A",
        "authorized_official_last_name": "KANDOTH",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-254-5437",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "9350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.