Individual provider Active NPI

Keir Hales, MD

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1508896689
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
10496 Issued in NV
Practice address
2020 Palomino LN
Ste 100
Las Vegas, NV 89106-4894
Phone
(702) 759-8600
Fax
(702) 384-1815
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 10496 NV Primary

Addresses

Primary practice location

2020 Palomino LN
Ste 100
Las Vegas, NV 89106-4894

Mailing address

2020 Palomino LN
Las Vegas, NV 89106-4894
Phone (702) 759-8600

Other identifiers 5

IdentifierTypeStateIssuer
P00052682OtherNVRRMC
200468540AMedicaidOK
201890010MedicaidNV
1508896689MedicaidCA
P01168985OtherNVRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040210000289 NV Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 8426942848 Reassigns benefits to 3 organizations
I20240501003490 WA Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 8426942848 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine
Education
University of Utah School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smi Imaging LLCGroup PAC ID 3476696220, 380 clinicians

Practice addresses (Care Compare)

5653 171St Ave SE
Aditi D Modi MD
Bellevue, WA 98006-5505
Phone (480) 306-6949

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
75.71
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10496NVMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Bandt Birkin Kollins & Wong PLLC Diagnostic Radiology CurrentSince Aug 1, 2003 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Aug 13, 2019 Accepting new patients
Shelin Agrawal and Hyer PLLC Diagnostic Radiology CurrentSince Jan 21, 2012 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Aug 13, 2019 Accepting new patients
Mountain Medical Physician Specialists PC Diagnostic Radiology Past Accepting new patients

Locations

2811 W Horizon Ridge Pkwy
Henderson, NV 89052

2020 Palomino Ln
Las Vegas, NV 89106
Phone (702) 384-5210

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

2020 Palomino Ln
Ste 100
Las Vegas, NV 89106
Phone (702) 759-8779

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: khales18496@direct.umcsn.com

Organizations & group practices 7

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1508896689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "address_2": "STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALES",
        "first_name": "KEIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "10496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "P00052682",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200468540A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201890010",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508896689",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01168985",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.