Individual provider Active NPI

Anis Abi-Karam, PHD

  • Psychologist
  • Las Vegas, NV
National Provider Identifier
1619121456
Registry record updated Nov 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
2740 S Jones Blvd
Las Vegas, NV 89146-5306
Phone
(702) 248-8866
Fax
(702) 248-6920
NPI assigned
Nov 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

2740 S Jones Blvd
Las Vegas, NV 89146-5306

Mailing address

2740 S Jones Blvd
Las Vegas, NV 89146-5306
Phone (702) 248-8866

Other identifiers 2

IdentifierTypeStateIssuer
S03770OtherNVMEDICARE ID
002602049MedicaidNV

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050927001133 NV Practitioner - Clinical Psychologist 9234164484 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anis Abi-Karam LTD CurrentSince Apr 29, 2009 Accepting new patients
Anis Abi-Karam LTD Psychologist Past Accepting new patients
Anis Abi-Karam LTD Past Accepting new patients

Locations

2740 S Jones Blvd
Las Vegas, NV 89146
Phone (702) 248-8866

Organizations & group practices 3

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": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226361600000",
    "number": "1619121456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465306",
            "telephone_number": "702-248-8866",
            "fax_number": "702-248-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465306",
            "telephone_number": "702-248-8866",
            "fax_number": "702-248-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABI-KARAM",
        "first_name": "ANIS",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-06",
        "last_updated": "2008-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "S03770",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002602049",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.