Individual provider Active NPI

Benjamin Casillas, MD

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1578739835
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17899 Issued in NV
Practice address
6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone
(702) 952-9171
Fax
(702) 952-9170
NPI assigned
May 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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 A103128 CA
Hospitalist Physician 208M00000X A103128 CA
Family Medicine Physician 207Q00000X 17899 NV Primary

Addresses

Primary practice location

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133

Mailing address

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone (702) 216-3346

Other practice location 1

1000 S Rainbow Blvd
Las Vegas, NV 89145
Phone (702) 952-9171

Other identifiers 2

IdentifierTypeStateIssuer
17899OtherNVNV STATE LICENSE
1578739835MedicaidNV

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
I20180718004214 NV Practitioner - Family Practice 1153492970 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103128CAMDGeneral Practice Dentistry
A103128CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 29, 2022 Accepting new patients
Intermountain Medical Holdings Nevada Inc Family Medicine CurrentSince Jan 29, 2022 Accepting new patients
Healthcare Partners Medical Group Coats LTD Family Medicine Current Accepting new patients

Locations

595 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 566-5500

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

6355 S Buffalo Dr
Las Vegas, NV 89113
Phone (702) 952-9171

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

Organizations & group practices 3

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": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1578739835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-952-9171",
            "fax_number": "702-952-9170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 S Rainbow Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "89145",
            "country_code": "US",
            "telephone_number": "702-952-9171",
            "fax_number": "702-952-9136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASILLAS",
        "first_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-06",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A103128",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A103128",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "17899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV  STATE LICENSE",
            "identifier": "17899",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578739835",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.