NPIMap

Organization Active NPI

Kittusamy, LLP

Doing business as Las Vegas Metabolic & Hormonal Medicine

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1558749168
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KITTUSAMY, LLP
Doing business as
Las Vegas Metabolic & Hormonal Medicine
Practice address
401 N Buffalo Dr
Suite 100
Las Vegas, NV 89145-0310
Phone
(702) 853-5681
Fax
(702) 675-6971
NPI assigned
May 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Authorized official

Name
Prem Kittusamy, MD
Title
Owner
Phone
(702) 589-2750

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Obesity Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QB0002X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X

Addresses

Primary practice location

401 N Buffalo Dr
Suite 100
Las Vegas, NV 89145-0310

Mailing address

401 N Buffalo Dr
Suite 100
Las Vegas, NV 89145-0310
Phone (702) 853-5681

Other names 1

  • Las Vegas Metabolic & Hormonal Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kittusamy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

401 N Buffalo Dr
Ste 100
Las Vegas, NV 89145
Phone (702) 489-9000

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72761

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1558749168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N BUFFALO DR",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891450310",
            "telephone_number": "702-853-5681",
            "fax_number": "702-675-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N BUFFALO DR",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891450310",
            "telephone_number": "702-853-5681",
            "fax_number": "702-675-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITTUSAMY, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "KITTUSAMY",
        "authorized_official_first_name": "PREM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-589-2750",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Las Vegas Metabolic & Hormonal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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, 2015; 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.