Individual provider Active NPI

Lisa M Marciniak, CST, CFA, OPA-C

  • Surgical Assistant
  • Las Vegas, NV
National Provider Identifier
1528337177
Registry record updated Dec 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
Practice address
2650 N Tenaya Way
#301
Las Vegas, NV 89128-1102
Phone
(702) 878-0393
Fax
(702) 939-5014
NPI assigned
Dec 27, 2011
Last updated
Dec 27, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X Primary

Addresses

Primary practice location

2650 N Tenaya Way
#301
Las Vegas, NV 89128-1102

Mailing address

2650 N Tenaya Way
#301
Las Vegas, NV 89128-1102
Phone (702) 878-0393

Other identifiers 1

IdentifierTypeStateIssuer
081087OtherNVNATIONAL BOARD OF SURGICAL TECHNOLOGY & SURGICAL ASSISTING CERTIFICATE NUMBER

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1528337177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 N TENAYA WAY",
            "address_2": "#301",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281102",
            "telephone_number": "702-878-0393",
            "fax_number": "702-939-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 N TENAYA WAY",
            "address_2": "#301",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281102",
            "telephone_number": "702-878-0393",
            "fax_number": "702-939-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCINIAK",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "CST, CFA, OPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-27",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL BOARD OF SURGICAL TECHNOLOGY & SURGICAL ASSISTING CERTIFICATE NUMBER",
            "identifier": "081087",
            "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 Dec 27, 2011; 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.