Individual provider Active NPI

Thomas Raymond Land, MD

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1639142052
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11546 Issued in NV
Practice address
6970 W. Patrick Lane
Suite #140
Las Vegas, NV 89113-0270
Phone
(702) 450-1717
Fax
(702) 947-6740
NPI assigned
Feb 8, 2006
Last updated
Aug 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11546 NV Primary

Addresses

Primary practice location

6970 W. Patrick Lane
Suite #140
Las Vegas, NV 89113-0270

Mailing address

6970 W. Patrick Lane
Suite #140
Las Vegas, NV 89113-0270
Phone (702) 450-1717

Other identifiers 2

IdentifierTypeStateIssuer
100507214MedicaidNV
100507151MedicaidNV

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
I20051006000744 NV Practitioner - Family Practice 5193627446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3100 N Tenaya Way
Las Vegas, NV 89128-0436
Phone (702) 255-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas R Land MD PC Family Medicine CurrentSince Dec 15, 2008 Accepting new patients
Optumcare Florida LLC Family Medicine Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Optumcare Florida, LLC Past Accepting new patients

Locations

3022 S Durango Dr
Ste 100
Las Vegas, NV 89117
Phone (702) 210-9423

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

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 1

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1639142052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6970 W. PATRICK LANE",
            "address_2": "SUITE #140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891130270",
            "telephone_number": "702-450-1717",
            "fax_number": "702-947-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6970 W. PATRICK LANE",
            "address_2": "SUITE #140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891130270",
            "telephone_number": "702-450-1717",
            "fax_number": "702-947-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAND",
        "first_name": "THOMAS",
        "middle_name": "RAYMOND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "11546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100507214",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100507151",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.