Individual provider Active NPI

Charles H Weintz, DO

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1629021795
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO1825 Issued in NV
Practice address
888 S Rancho Dr
Las Vegas, NV 89106-3810
Phone
(702) 877-8600
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 05-31005 KS
Family Medicine Physician 207Q00000X DO1825 NV Primary

Addresses

Primary practice location

888 S Rancho Dr
Las Vegas, NV 89106-3810

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-8600

Other identifiers 2

IdentifierTypeStateIssuer
200383230MedicaidKS
1629021795OtherNVSMA MEDICAID

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140716002018 NV Practitioner - Family Practice 8022908599 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

2704 N Tenaya Way
Las Vegas, NV 89128-0424
Phone (702) 579-3253

2716 N Tenaya Way
Las Vegas, NV 89128-0424
Phone (702) 579-3253

2845 Siena Heights Dr
Henderson, NV 89052-4153
Phone (702) 579-3253

7061 Grand Montecito Pkwy
Las Vegas, NV 89149-0287
Phone (702) 579-3253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05-31005KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group II Rhodes P C CurrentSince Jun 3, 2019 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Jun 3, 2019 Accepting new patients
Southwest Medical Associates, Inc CurrentSince May 5, 2014 Accepting new patients

Locations

888 S Rancho Dr
Las Vegas, NV 89106
Phone (702) 877-5375

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

Interoperability endpoints

  • Direct secure messaging: cweintz119238@westdirect.optum.com

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1629021795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S RANCHO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063810",
            "telephone_number": "702-877-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINTZ",
        "first_name": "CHARLES",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "05-31005",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO1825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200383230",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SMA MEDICAID",
            "identifier": "1629021795",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.