NPIMap

Individual provider Active NPI

Kasey Laz Abanonu Jr., MD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1609109644
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14139 Issued in NV
Practice address
2100 W Charleston Blvd
Las Vegas, NV 89102-2224
Phone
(702) 383-2000
NPI assigned
Sep 9, 2009
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14139 NV Primary

Addresses

Primary practice location

2100 W Charleston Blvd
Las Vegas, NV 89102-2224

Mailing address

1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone (702) 383-2000

Other identifiers 2

IdentifierTypeStateIssuer
1609109644MedicaidNV
V75834OtherNVMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120517000595 NV Practitioner - Internal Medicine 7113063173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4919 W Craig Rd
Las Vegas, NV 89130-2730
Phone (725) 220-8706

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14139NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care (NV) PC Family Medicine CurrentSince Nov 14, 2022 Accepting new patients
Centerwell Senior Primary Care (NV) PC Family Medicine CurrentSince Nov 14, 2022 Accepting new patients
Centerwell Senior Primary Care (NV) PC Family Medicine Past Accepting new patients
Hospital Medicine Associates LLC Family Medicine Past Accepting new patients
Centerwell Senior Primary Care NV P C Family Medicine Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients
Inpatient Consultants of Nevada, Inc. a Medical Corporation Internal Medicine Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
DCH Provider Services, LLC Past Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

4700 Millenia Blvd
Ste 650
Orlando, FL 32839
Phone (407) 533-6837

10180 W Tropicana Ave
Ste 136
Las Vegas, NV 89147
Phone (702) 848-3554

3129 N Rainbow Blvd
Las Vegas, NV 89108
Phone (725) 220-8457

4001 S Decatur Blvd
Ste 25
Las Vegas, NV 89103
Phone (725) 224-6967

4919 W Craig Rd
Las Vegas, NV 89130
Phone (725) 220-8706

Interoperability endpoints

  • Direct secure messaging: kasey.abanonu.1@29601.direct.athenahealth.com
  • Direct secure messaging: kasey.abanonu@centerwell.eclinicaldirectplus.com

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1609109644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022329",
            "telephone_number": "702-383-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022224",
            "telephone_number": "702-383-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABANONU",
        "first_name": "KASEY",
        "middle_name": "LAZ",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "14139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609109644",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "V75834",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.