Organization Active NPI

Mark C Handelman MD LTD

  • Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1568505295
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
6880 Issued in NV
Legal business name
MARK C HANDELMAN MD LTD
Practice address
2585 Box Canyon Dr
Suite 110
Las Vegas, NV 89128-0429
Phone
(702) 538-7773
Fax
(702) 256-9035
NPI assigned
Feb 14, 2007
Last updated
Aug 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Authorized official

Name
Mark C Handelman, MDNPI 1194798132
Title
Owner
Phone
(702) 538-7773

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
Clinic/Center 261Q00000X 6880 NV Primary

Addresses

Primary practice location

2585 Box Canyon Dr
Suite 110
Las Vegas, NV 89128-0429

Mailing address

2585 Box Canyon Dr
Suite 110
Las Vegas, NV 89128-0429
Phone (702) 538-7773

Other identifiers 1

IdentifierTypeStateIssuer
V103413OtherNVMEDICARE ID- UNSPECIFIED

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070314000011 NV Part B Supplier - Clinic/Group Practice 6002919974 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

2585 Box Canyon Dr
Las Vegas, NV 89128
Phone (702) 538-7773

2585 Box Canyon Dr
Ste 110
Las Vegas, NV 89128
Phone (702) 538-7773

3150 N Tenaya Way
Ste 565
Las Vegas, NV 89128
Phone (702) 254-8900

Practitioners & affiliated clinicians

Practitioners 3

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": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1568505295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 BOX CANYON DR",
            "address_2": "SUITE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280429",
            "telephone_number": "702-538-7773",
            "fax_number": "702-256-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 BOX CANYON DR",
            "address_2": "SUITE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280429",
            "telephone_number": "702-538-7773",
            "fax_number": "702-256-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK C HANDELMAN MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "HANDELMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-538-7773",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NV",
            "license": "6880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID- UNSPECIFIED",
            "identifier": "V103413",
            "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 Aug 13, 2013; 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.