NPIMap

Individual provider Active NPI

Dzmitry Fursevich, MD

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1629331830
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D83737 Issued in MD
Practice address
2040 W Charleston Blvd Ste 504
Las Vegas, NV 89102-2207
Phone
(702) 671-6437
NPI assigned
Jun 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 17808 NV
Diagnostic Radiology Physician 2085R0202X D83737 MD Primary

Addresses

Primary practice location

2040 W Charleston Blvd Ste 504
Las Vegas, NV 89102-2207

Mailing address

PO Box 7055
Reno, NV 89510-7055
Phone (410) 955-4567

Other practice location 1

1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181015000158 NV Practitioner - Diagnostic Radiology 0143591396 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Nevada School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians

Practice addresses (Care Compare)

1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.44 of 100Reported as group
Quality
80
Improvement activities
40
Cost
78.13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC Family Medicine Current Accepting new patients
Community Care Services LLC CurrentSince May 1, 2025 Accepting new patients
Community Care Services LLC Diagnostic Radiology CurrentSince May 1, 2025 Accepting new patients
Reno Radiological Associates, Chartered Diagnostic Radiology CurrentSince Aug 7, 2018 Accepting new patients

Locations

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

75 Pringle Way
Reno, NV 89502
Phone (775) 327-4673

Organizations & group practices 4

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1629331830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7055",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895107055",
            "telephone_number": "410-955-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 W CHARLESTON BLVD STE 504",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022207",
            "telephone_number": "702-671-6437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 Mill St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895021576",
            "country_code": "US",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FURSEVICH",
        "first_name": "DZMITRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-21",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "17808",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D83737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.