Individual provider Active NPI

Robert J Mazo, D.O.

  • Neurology Physician
  • Las Vegas, NV
National Provider Identifier
1528042660
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
DO2446 Issued in NV
Practice address
1707 W Charleston Blvd Ste 230
Las Vegas, NV 89102-2353
Phone
(702) 671-5060
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 34002343 OH
Neurology Physician 2084N0400X DO2446 NV Primary

Addresses

Primary practice location

1707 W Charleston Blvd Ste 230
Las Vegas, NV 89102-2353

Mailing address

700 Ackerman Rd
Suite 570
Columbus, OH 43202-1559
Phone (614) 293-4969

Other practice location 1

1707 W Charleston Blvd Ste 230
Las Vegas, NV 89102-2353
Phone (702) 671-5060

Other identifiers 1

IdentifierTypeStateIssuer
0274920MedicaidOH

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
I20191002000932 NV Practitioner - Neurology 2365403029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Practice addresses (Care Compare)

1707 W Charleston Blvd
Las Vegas, NV 89102-2352

1707 W Charleston Blvd
Las Vegas, NV 89102-2353

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO2446NVMDNeurology Physician
34002343OHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine CurrentSince Aug 4, 2019 Accepting new patients
Unlv Medicine CurrentSince Aug 4, 2019 Accepting new patients
Unlv Medicine Current Accepting new patients
Dignity Health Past Accepting new patients
Osu Neuroscience Center, LLC Neurology Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients

Locations

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

1707 W Charleston Blvd
Ste 230
Las Vegas, NV 89102
Phone (702) 671-5060

1707 W Charleston Blvd
Ste 290
Las Vegas, NV 89102
Phone (702) 671-5139

3016 W Charleston Blvd
Ste 205
Las Vegas, NV 89102
Phone 7027802312 ext. 2312

Organizations & group practices 9

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1528042660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD",
            "address_2": "SUITE 570",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-4969",
            "fax_number": "614-293-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W CHARLESTON BLVD STE 230",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022353",
            "telephone_number": "702-671-5060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1707 W Charleston Blvd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891022353",
            "country_code": "US",
            "telephone_number": "702-671-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZO",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "34002343",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NV",
            "license": "DO2446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0274920",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.