NPIMap

Individual provider Active NPI

Carmelo Herrero, M.D.

  • Gastroenterology Physician
  • Henderson, NV
National Provider Identifier
1619078607
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
8613 Issued in NV
Practice address
825 N Gibson Rd Ste 201
Henderson, NV 89011-1708
Phone
(702) 492-1162
Fax
(702) 492-1319
NPI assigned
Sep 25, 2006
Last updated
Feb 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 8613 NV Primary

Addresses

Primary practice location

825 N Gibson Rd Ste 201
Henderson, NV 89011-1708

Mailing address

2345 E Prater Way Ste 207
Sparks, NV 89434-9634
Phone (702) 492-1162

Other identifiers 2

IdentifierTypeStateIssuer
002002417MedicaidNV
1619078607MedicaidNV

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
I20080515000558 NV Practitioner - Gastroenterology 8426940396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Ponce School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Las Vegas Medical Group LLCGroup PAC ID 6800118522, 51 clinicians

Practice addresses (Care Compare)

1389 Galleria Dr
Suite 100
Henderson, NV 89014-6686
Phone (725) 333-8400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy60
Upper gastrointestinal (GI) endoscopy for acid reflux104

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Las Vegas Medical Group LLC Family Medicine CurrentSince Aug 27, 2018 Accepting new patients
Desert Springs Hospital Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients
North Vista Hospital LLC Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients

Locations

1389 Galleria Dr
Ste 100
Henderson, NV 89014
Phone (725) 333-8400

2625 Wigwam Pkwy
Ste 112
Henderson, NV 89074
Phone (702) 255-5900

825 N Gibson Rd
Ste 201
Henderson, NV 89011
Phone (702) 492-1162

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1619078607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 E PRATER WAY STE 207",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894349634",
            "telephone_number": "702-492-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 N GIBSON RD STE 201",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890111708",
            "telephone_number": "702-492-1162",
            "fax_number": "702-492-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERO",
        "first_name": "CARMELO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NV",
            "license": "8613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002002417",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619078607",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.