Individual provider Active NPI

Michael Andrew Naegle, MD

  • Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1619544129
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25963 Issued in NV
Practice address
1524 Pinto LN FL 3
Las Vegas, NV 89106-4195
Phone
(702) 944-2828
Fax
(702) 944-2852
NPI assigned
Jun 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 16744 SD
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 25963 NV Primary

Addresses

Primary practice location

1524 Pinto LN FL 3
Las Vegas, NV 89106-4195

Mailing address

3016 W Charleston Blvd Ste 100
Las Vegas, NV 89102-1973
Phone (027) 802-3157

Other practice location 1

1400 W 22nd St
Sioux Falls, SD 57105-1554
Phone (605) 333-7197

Other practice location 2

1702 E Austin St
Sioux Falls, SD 57103-1542
Phone (801) 889-6291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230725003088 SD Practitioner - Pediatric Medicine 5698172039 Reassigns benefits to 2 organizations
I20250307002156 NV Practitioner - Pediatric Medicine 5698172039 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0632SDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic CurrentSince Jan 3, 2025 Accepting new patients
Unlv Medicine CurrentSince Feb 11, 2025 Accepting new patients
Sanford Clinic Current Accepting new patients
Unlv Medicine Current Accepting new patients
Unlv Medicine CurrentSince Feb 11, 2025 Accepting new patients

Locations

3016 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 780-2315

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

1524 Pinto Ln
Fl 3
Las Vegas, NV 89106
Phone (702) 944-2828

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

6110 S Minnesota Ave
Sioux Falls, SD 57108
Phone (605) 328-5800

136 S Phillips Ave
Ste 102
Sioux Falls, SD 57104

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1619544129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021973",
            "telephone_number": "027-802-3157",
            "fax_number": "702-895-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 PINTO LN FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064195",
            "telephone_number": "702-944-2828",
            "fax_number": "702-944-2852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 W 22nd St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571051554",
            "country_code": "US",
            "telephone_number": "605-333-7197",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1702 E Austin St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571031542",
            "country_code": "US",
            "telephone_number": "801-889-6291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAEGLE",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-04",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SD",
            "license": "16744",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "25963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.