Active NPI
Faezeh Izadmanesh, MD
- Family Medicine Physician
- Las Vegas, NV
National Provider Identifier
1487836748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 13589
- Practice address
- 9010 W Cheyenne Ave
Las Vegas, NV 89129-8932 - Phone
- (702) 240-8646
- Fax
- (702) 240-0206
- NPI assigned
- Nov 28, 2007
- Last updated
- Oct 6, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 13589 | NV | Primary |
Addresses
Primary practice location
9010 W Cheyenne Ave
Las Vegas, NV 89129-8932
Mailing address
9010 W Cheyenne Ave
Las Vegas, NV 89129-8932
Phone (702) 240-8646
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13589 | NV | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alfaro LTD | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412553600000",
"number": "1487836748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9010 W CHEYENNE AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891298932",
"telephone_number": "702-240-8646",
"fax_number": "702-240-0206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9010 W CHEYENNE AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891298932",
"telephone_number": "702-240-8646",
"fax_number": "702-240-0206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IZADMANESH",
"first_name": "FAEZEH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-28",
"last_updated": "2014-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "13589",
"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 Oct 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.