NPIMap

Organization Active NPI

Boulder City Hospital Inc.

Doing business as Boulder City Surgical Group

  • Critical Access Hospital
  • Boulder City, NV
National Provider Identifier
1619739117
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
BOULDER CITY HOSPITAL INC.
Doing business as
Boulder City Surgical Group
Practice address
999 Adams Blvd
Boulder City, NV 89005-2244
Phone
(702) 294-5750
NPI assigned
Jan 29, 2024
Last updated
Feb 14, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BOULDER CITY HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Authorized official

Name
Douglas B Lewis
Title
Chief Financial Officer
Phone
(702) 293-4111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

999 Adams Blvd
Boulder City, NV 89005-2244

Mailing address

901 Adams Blvd
Boulder City, NV 89005-2213
Phone (702) 293-4111

Other names 1

  • Boulder City Surgical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180205001368 NV Part B Supplier - Clinic/Group Practice 7618953795 Receives reassigned benefits from 9 practitioners
2 other NPIs on this enrollment
Practice locations: Boulder City, NV

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
R Pramod Kumar MD

Locations

901 Adams Blvd
Boulder City, NV 89005
Phone (702) 293-4111

Practitioners & affiliated clinicians

Practitioners 10

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": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1619739117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 ADAMS BLVD",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890052213",
            "telephone_number": "702-293-4111",
            "fax_number": "702-294-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 ADAMS BLVD",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890052244",
            "telephone_number": "702-294-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER CITY HOSPITAL INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOULDER CITY HOSPITAL INC",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "702-293-4111"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boulder City Surgical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Boulder City Surgical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boulder City, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.