Individual provider Active NPI

Robert G Wiencek, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Las Vegas, NV
National Provider Identifier
1609902279
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
6210 Issued in NV
Practice address
7190 S Cimarron Rd
Las Vegas, NV 89113-2171
Phone
(702) 675-3240
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 6210 NV Primary

Addresses

Primary practice location

7190 S Cimarron Rd
Las Vegas, NV 89113-2171

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (702) 616-5801

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
I20101101000252 NV Practitioner - Cardiac SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular Surgery 5698661411 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6210NVMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Group Nevada, LLC CurrentSince Apr 1, 2013 Accepting new patients
Dignity Health Current Accepting new patients
Dignity Health CurrentSince Apr 1, 2013 Accepting new patients
Cardiovascular Surgery Associates Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Oct 1, 2010 Accepting new patients
Stanford Health Care Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

10001 S Eastern Ave
Ste 203
Henderson, NV 89052
Phone (702) 616-5915

2865 Siena Heights Dr
Ste 131
Henderson, NV 89052
Phone (702) 616-6580

7190 S Cimarron Rd
Las Vegas, NV 89113
Phone (702) 675-3240

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.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1609902279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "702-616-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7190 S CIMARRON RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132171",
            "telephone_number": "702-675-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENCEK",
        "first_name": "ROBERT",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NV",
            "license": "6210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.