Individual provider Active NPI

Mark Christopher Dugan, M.D.

  • Pediatric Critical Care Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1578724555
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
15904 Issued in NV
Practice address
1800 W Charleston Blvd
4TH Floor - Pediatric Critical Care
Las Vegas, NV 89102-2329
Phone
(702) 383-2420
NPI assigned
Jun 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 35.097064 OH
Pediatrics Physician 208000000X 067558 GA
Pediatric Critical Care Medicine Physician 2080P0203X 15904 NV Primary

Addresses

Primary practice location

1800 W Charleston Blvd
4TH Floor - Pediatric Critical Care
Las Vegas, NV 89102-2329

Mailing address

12216 Capilla Real Ave
Las Vegas, NV 89138-4543
Phone (216) 225-9852

Other identifiers 1

IdentifierTypeStateIssuer
0050325MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20151002002646 NV Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 1951589704 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
067558GAMDPediatrics Physician
35.097064OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Center of Southern Nevada Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mdugan18604@direct.umcsn.com

Organizations & group practices 2

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": "1214092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1578724555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12216 CAPILLA REAL AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891384543",
            "telephone_number": "216-225-9852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W CHARLESTON BLVD",
            "address_2": "4TH FLOOR - PEDIATRIC CRITICAL CARE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022329",
            "telephone_number": "702-383-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGAN",
        "first_name": "MARK",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-22",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.097064",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "067558",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NV",
            "license": "15904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050325",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.