St Clare Medical Services Inc

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

NV9215 Issued in NV

Legal business name

ST CLARE MEDICAL SERVICES INC

Practice address

2525 W Charleston Blvd
Suite 100
Las Vegas, NV 89102-2127

Phone

(702) 878-2801

Fax

(702) 878-3050

NPI assigned

Sep 30, 2010

Last updated

Oct 11, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly Phan

Title

Billing Coordinator

Phone

(702) 808-4741

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Victor A Deleon, MD Other name

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Victor Atienza De Leon, M.D.

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1861564783
  Medicare reassignment NPD

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286755200000",
    "number": "1548579022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7582 LAS VEGAS BLVD S",
            "address_2": "SUITE 489",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891231009",
            "telephone_number": "702-878-2801",
            "fax_number": "702-878-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W CHARLESTON BLVD",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022127",
            "telephone_number": "702-878-2801",
            "fax_number": "702-878-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CLARE MEDICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-30",
        "last_updated": "2010-10-11",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "702-808-4741",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NV",
            "license": "NV9215",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NV",
            "license": "NV9215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018374",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victor A Deleon, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• SSCS Enterprises, LLC (Right at Home Las Vegas)
• SSM Health LLC
• Sspc1 LLC
• St Benedict
• Brad St Clair
• Deanna St Cyr, FNP-BC
• Charles Randolph St Hill, M.D., MSC
• St James Home Health Care LLC
• St Jean Senior Care
• Christine St Jean

• Preferred Provider Organization in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Preferred Provider Organization in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.