NPIMap

Individual provider Active NPI

Jared Miya, MD

  • Emergency Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1609404425
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
23734 Issued in NV
Practice address
901 Rancho LN Ste 135
Las Vegas, NV 89106-3826
Phone
(702) 383-7885
NPI assigned
Mar 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 23734 NV Primary

Addresses

Primary practice location

901 Rancho LN Ste 135
Las Vegas, NV 89106-3826

Mailing address

901 Rancho LN Ste 135
Las Vegas, NV 89106-3826
Phone (702) 383-7885

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
I20230808002822 NV Practitioner - Emergency Medicine 3173985108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rush Medical College of Rush University, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shadow Emergency Physicians PLLCGroup PAC ID 2860667375, 105 clinicians

Practice addresses (Care Compare)

7230 N Decatur Blvd
Las Vegas, NV 89131-2706
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Dec 18, 2023 Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine Current Accepting new patients
Fremont Emergency Services Scherr LTD Emergency Medicine Current Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Dec 18, 2023 Accepting new patients
Fremont Emergency Services Scherr LTD Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

7230 N Decatur Blvd
Las Vegas, NV 89131
Phone (702) 534-7200

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

10770 Las Vegas Blvd S
Las Vegas, NV 89183
Phone (702) 916-9002

3186 S Maryland Pkwy
Ste 410
Las Vegas, NV 89109

9300 W Sunset Rd
Las Vegas, NV 89148
Phone (702) 880-2100

3325 S Fort Apache Rd
Las Vegas, NV 89117
Phone (702) 962-0500

9075 Blue Diamond Rd
Las Vegas, NV 89178
Phone (702) 916-5000

7207 Aliante Pkwy
North Las Vegas, NV 89084
Phone (702) 962-5100

Organizations & group practices 5

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1609404425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 RANCHO LN STE 135",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063826",
            "telephone_number": "702-383-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 RANCHO LN STE 135",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063826",
            "telephone_number": "702-383-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYA",
        "first_name": "JARED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-28",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "23734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.