NPIMap

Organization Active NPI

Guanaroca Medical Center Inc

  • Primary Care Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1568032548
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
GUANAROCA MEDICAL CENTER INC
Practice address
5130 S Pecos Rd
Las Vegas, NV 89120-1201
Phone
(725) 205-3203
Fax
(725) 205-1861
NPI assigned
Jun 30, 2021
Last updated
Oct 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Authorized official

Name
Alexeis Ares-Gattorno, MBANPI 1992467815
Title
Ceo
Phone
(725) 400-6444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

5130 S Pecos Rd
Las Vegas, NV 89120-1201

Mailing address

68 Incline Village CT
Henderson, NV 89074-0693
Phone (725) 400-6444

Other identifiers 1

IdentifierTypeStateIssuer
1568032548MedicaidNV

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL ICANOTES Health Information Exchange (HIE)
CONNECT URL eclinicalWork Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211022001787 NV Part B Supplier - Clinic/Group Practice 1355739400 Receives reassigned benefits from 2 practitioners
Practice locations: Las Vegas, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2257231Guanaroca Medical Center Inc5130 S Pecos Rd, Unit 1a, Las Vegas, NV 89120Certificate of waiverMar 31, 2028

National Provider Directory

National Provider Directory

Locations

5130 S Pecos Rd
Las Vegas, NV 89120
Phone (702) 336-2968

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1568032548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 INCLINE VILLAGE CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890740693",
            "telephone_number": "725-400-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 S PECOS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891201201",
            "telephone_number": "725-205-3203",
            "fax_number": "725-205-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUANAROCA MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "ARES-GATTORNO",
        "authorized_official_first_name": "ALEXEIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "725-400-6444",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568032548",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ICANOTES",
            "affiliation": "N",
            "endpointDescription": "Electronic Health care record",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5130 S Pecos Rd Ste 1A",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891201248",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "eclinicalWork",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5130 S Pecos Rd Ste 1A",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891201248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.