Individual provider Active NPI

Andrew Richard Jacinto, DPT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1659827566
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3416 Issued in NV
Practice address
10550 Park Run Dr
Las Vegas, NV 89144-4575
Phone
(702) 515-6200
NPI assigned
Aug 31, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3416 NV Primary

Addresses

Primary practice location

10550 Park Run Dr
Las Vegas, NV 89144-4575

Mailing address

1022 Valley Light Ave
Henderson, NV 89011-2650
Phone (951) 813-8926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3416NVMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1659827566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 VALLEY LIGHT AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890112650",
            "telephone_number": "951-813-8926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10550 PARK RUN DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891444575",
            "telephone_number": "702-515-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACINTO",
        "first_name": "ANDREW",
        "middle_name": "RICHARD",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "3416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.