Individual provider Active NPI

Benjamin O Nolasco, MD

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1568049997
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23887 Issued in NV
Practice address
7061 Grand Montecito Pkwy
Las Vegas, NV 89149-0287
Phone
(702) 877-5199
Fax
(534) 429-9026
NPI assigned
Mar 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23887 NV
Family Medicine Physician 207Q00000X 23887 NV Primary
Adult Medicine Physician 207QA0505X 23887 NV

Addresses

Primary practice location

7061 Grand Montecito Pkwy
Las Vegas, NV 89149-0287

Mailing address

4300 Plattsburgh Ave BLDG 332
Nellis Afb, NV 89191-6302
Phone (702) 653-2273

Other practice location 1

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone (702) 653-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230821002867 NV Practitioner - General Practice 4688062250 Reassigns benefits to 1 organization
I20230914002373 NV Practitioner - Family Practice 4688062250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

7061 Grand Montecito Pkwy
Las Vegas, NV 89149-0287
Phone (702) 579-3253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23887NVMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group II Rhodes P C Internal Medicine CurrentSince Aug 15, 2024 Accepting new patients
Signify Health Medical Associates, PLLC General Practice CurrentSince Aug 8, 2023 Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients
Southwest Medical Associates, Inc Internal Medicine Past Accepting new patients

Locations

701 S Carson St
Ste 200
Carson City, NV 89701
Phone (617) 586-0958

7061 Grand Montecito Pkwy
Las Vegas, NV 89149
Phone (702) 750-3800

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

7061 Grand Montecito Pkwy
Fl 2
Las Vegas, NV 89149

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: bnolasco119209@westdirect.optum.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1568049997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 PLATTSBURGH AVE BLDG 332",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916302",
            "telephone_number": "702-653-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7061 GRAND MONTECITO PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891490287",
            "telephone_number": "702-877-5199",
            "fax_number": "534-429-9026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Las Vegas Blvd N",
            "address_purpose": "LOCATION",
            "city": "Nellis AFB",
            "state": "NV",
            "postal_code": "891916600",
            "country_code": "US",
            "telephone_number": "702-653-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLASCO",
        "first_name": "BENJAMIN",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "23887",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "23887",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NV",
            "license": "23887",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.