Individual provider Active NPI

Marcelino Cucio Belizario, M.D.

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1639172448
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10906 Issued in NV
Practice address
1000 S Rainbow Blvd
Ste. a
Las Vegas, NV 89145-6231
Phone
(702) 464-8866
Fax
(702) 671-6851
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10906 NV Primary

Addresses

Primary practice location

1000 S Rainbow Blvd
Ste. a
Las Vegas, NV 89145-6231

Mailing address

PO Box 98978
Las Vegas, NV 89193-8978
Phone (702) 507-2466

Other identifiers 1

IdentifierTypeStateIssuer
1639172448MedicaidNV

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
I20040719000520 NV Practitioner - Internal Medicine 1658350004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Calaguas LTDGroup PAC ID 4587795091, 5 clinicians

Practice addresses (Care Compare)

3000 W Charleston Blvd
Suite 1
Las Vegas, NV 89102-1981
Phone (702) 877-9511

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10906NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Calaguas LTD Internal Medicine CurrentSince Aug 19, 2023 Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Intermountain Medical Holdings Nevada Inc Family Medicine Past Accepting new patients
Conway Regional Medical Center Inc Family Medicine Past Accepting new patients
J Corey Brown MD Fremont Medical Center LTD Internal Medicine Past Accepting new patients
Dignity Health Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients

Locations

3000 W Charleston Blvd
Ste 3
Las Vegas, NV 89102

3009 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 453-4042

3000 W Charleston Blvd
Ste 1
Las Vegas, NV 89102
Phone (702) 870-1114

3000 W Charleston Blvd
Ste 5
Las Vegas, NV 89102
Phone (702) 623-7205

Organizations & group practices 7

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1639172448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98978",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891938978",
            "telephone_number": "702-507-2466",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S RAINBOW BLVD",
            "address_2": "STE. A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891456231",
            "telephone_number": "702-464-8866",
            "fax_number": "702-671-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELIZARIO",
        "first_name": "MARCELINO",
        "middle_name": "CUCIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "10906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639172448",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.