Individual provider Active NPI

Jon L Siems, M.D.

  • Specialist
  • Las Vegas, NV
National Provider Identifier
1528068640
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9250 Issued in NV
Practice address
3810 E Flamingo Rd
Las Vegas, NV 89121-6227
Phone
(702) 948-2010
Fax
(702) 920-8787
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9250 NV Primary
Ophthalmology Physician 207W00000X 9250 NV

Addresses

Primary practice location

3810 E Flamingo Rd
Las Vegas, NV 89121-6227

Mailing address

3810 E Flamingo Rd
Las Vegas, NV 89121-6227
Phone (702) 948-2010

Other identifiers 1

IdentifierTypeStateIssuer
2018998MedicaidNV

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9250NVMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Luis a Moreno Jr MD Professional Corporation CurrentSince Dec 29, 2024 Accepting new patients
Sand Past Accepting new patients

Locations

3810 E Flamingo Rd
Las Vegas, NV 89121
Phone (702) 948-2010

Organizations & group practices 2

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1528068640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 E FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891216227",
            "telephone_number": "702-948-2010",
            "fax_number": "702-920-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 E FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891216227",
            "telephone_number": "702-948-2010",
            "fax_number": "702-920-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEMS",
        "first_name": "JON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "9250",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NV",
            "license": "9250",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018998",
            "state": "NV"
        }
    ],
    "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 May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.