Mary Jane Magruder, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

8314 Issued in NV

Practice address

2020 Palomino LN
Suite 100
Las Vegas, NV 89106-4894

Phone

(702) 759-8600

Fax

(702) 384-1815

NPI assigned

Jun 12, 2006

Last updated

Nov 19, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: mmagruder12960@direct.umcsn.com

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.

• Ellis Bandt Birkin Kollins & Wong PLLC

  dba Desert Radiology

  • Diagnostic Radiology Physician
  • Las Vegas, NV
  • NPI 1578584678

  MS

  Medicare reassignment
• Shelin Agrawal and Hyer PLLC

  dba Desert Radiology Solutions

  • Diagnostic Radiology Physician
  • Las Vegas, NV
  • NPI 1861783961

  MS

  Medicare reassignment

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1649212564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "address_2": "STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGRUDER",
        "first_name": "MARY",
        "middle_name": "JANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "8314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200290024",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01168764",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200471160A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649212564",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Littman Magpantay
• Rianna Magpantay
• Sarah Aguiluz Magpayo, FNP-BC
• Irma Magrdichian
• Leo James Magrdichian, MSW, LSW, LADC
• Mags Heart NV
• Elizabeth J Magsanoc, CRNA
• Melvin Luistro Magsino, DPT
• Carmelita Magsumbol-Lukban, P.T.
• Maria Carmela Magtoto, APRN

• Diagnostic Radiology Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Diagnostic Radiology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.