Dalton Laut, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1505 Wigwam Pkwy Ste 330
Henderson, NV 89074-8195

Phone

(702) 878-0393

NPI assigned

May 26, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Img Medical Group de PAGroup PAC ID 4789044348, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: daltonlaut@nosc.allscriptsdirect.net

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.

• Img Medical Group de PA

  • Sports Medicine (Family Medicine) Physician
  • Boynton Beach, FL
  • NPI 1720708589

  NV

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1619542099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7455 W WASHINGTON AVE STE 160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891284356",
            "telephone_number": "702-878-0393",
            "fax_number": "702-258-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 WIGWAM PKWY STE 330",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890748195",
            "telephone_number": "702-878-0393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 S Rancho Dr Ste F1",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891063814",
            "country_code": "US",
            "telephone_number": "702-474-4454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4440 Elk Point Cir",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891476205",
            "country_code": "US",
            "telephone_number": "610-428-5896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Elk Point Circle",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "89147",
            "country_code": "US",
            "telephone_number": "610-428-5896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAUT",
        "first_name": "DALTON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-26",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camella Marisse Naraval Lau, RN
• Cynthia Lau, OTR
• Joseph Lau, APRN
• Amanda Michelle Lauber
• Laura M. Bruse, M.D., P.C. (Beautiful Bones Orthopaedics)
• Russell Tad Lauver, DO
• Jasmine Lavarias, LAT, ATC
• Hava G Lavine, APN
• Ashley Lawhn, DNP
• Lawrence D Gardner MD FRCS C Professional Corporation

• Physician Assistant in Henderson, NV
• Providers in Henderson, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.