Active NPI
Jon L Siems, M.D.
- Specialist
- Las Vegas, NV
National Provider Identifier
1528068640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 9250
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2018998 | Medicaid | NV |
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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9250 | NV | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luis a Moreno Jr MD Professional Corporation | Current | 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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Las Vegas, NV
- NPI 1467260026
-
- Optometrist
- Las Vegas, NV
- NPI 1538413802
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.