Individual provider Active NPI

Maria Emelina Quisumbing, M.D.

  • Hematology & Oncology Physician
  • Las Vegas, NV
National Provider Identifier
1508856022
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
10142 Issued in NV
Practice address
400 Shadow LN Ste 106
Las Vegas, NV 89106-4355
Phone
(702) 731-0909
Fax
(702) 826-4757
NPI assigned
Oct 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C135844 CA
Hematology & Oncology Physician 207RH0003X 10142 NV Primary

Addresses

Primary practice location

400 Shadow LN Ste 106
Las Vegas, NV 89106-4355

Mailing address

8936 Spanish Ridge Ave
Las Vegas, NV 89148-1354
Phone (702) 731-0909

Other identifiers 4

IdentifierTypeStateIssuer
115223MedicaidAZ
100507395MedicaidNV
1508856022MedicaidNV
P00320745OtherNVRAILROAD MEDICARE

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
I20210707000011 NV Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3375578784

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C135844CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleidoscope Comprehensive Care Current Accepting new patients
Aspirus Specialist Inc. Past Accepting new patients
Firstmed of Southern Nevada LLC PastSince Oct 31, 2007 Accepting new patients
Aspirus Specialists, Inc. Past Accepting new patients
Firstmed Health and Wellness Center Inc Internal Medicine PastSince Sep 1, 2010 Accepting new patients

Locations

4200 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 312-2233

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDEACA

Organizations & group practices 5

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1508856022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8936 SPANISH RIDGE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481354",
            "telephone_number": "702-731-0909",
            "fax_number": "702-998-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SHADOW LN STE 106",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064355",
            "telephone_number": "702-731-0909",
            "fax_number": "702-826-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUISUMBING",
        "first_name": "MARIA",
        "middle_name": "EMELINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C135844",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NV",
            "license": "10142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115223",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100507395",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508856022",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00320745",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.