Organization Active NPI

Clinica Medica del Pueblo

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1619110350
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLINICA MEDICA DEL PUEBLO
Practice address
216 N Lamb Blvd
Las Vegas, NV 89110-4674
Phone
(702) 459-2401
Fax
(702) 459-2405
NPI assigned
Apr 10, 2009
Last updated
Aug 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Authorized official

Name
Justo Sataray, MDNPI 1689619983
Title
MD/Ceo
Phone
(702) 459-2401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

216 N Lamb Blvd
Las Vegas, NV 89110-4674

Mailing address

216 N Lamb Blvd
Las Vegas, NV 89110-4674
Phone (702) 459-2401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090512000232 NV Part B Supplier - Clinic/Group Practice 2264431527 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Las Vegas, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2054391Clinica Medica del Pueblo216 N Lamb Blvd, Las Vegas, NV 89110Certificate of waiverFeb 19, 2027

National Provider Directory

National Provider Directory

Locations

224 N Lamb Blvd
Las Vegas, NV 89110
Phone (702) 459-2401

3365 E Flamingo Rd
Ste 3
Las Vegas, NV 89121
Phone (702) 434-6486

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786060800000",
    "number": "1619110350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 N LAMB BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891104674",
            "telephone_number": "702-459-2401",
            "fax_number": "702-459-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 N LAMB BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891104674",
            "telephone_number": "702-459-2401",
            "fax_number": "702-459-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA MEDICA DEL PUEBLO",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-10",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A",
        "authorized_official_last_name": "SATARAY",
        "authorized_official_first_name": "JUSTO",
        "authorized_official_title_or_position": "MD/CEO",
        "authorized_official_telephone_number": "702-459-2401",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.