Individual provider Active NPI

Abdul Tariq, D.O

  • Neurology Physician
  • Las Vegas, NV
National Provider Identifier
1669883534
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
DO2378 Issued in NV
Practice address
4275 Burnham Ave Ste 230
Las Vegas, NV 89119-5400
Phone
(702) 956-0996
Fax
(702) 965-2216
NPI assigned
May 14, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X DO2378 NV Primary

Addresses

Primary practice location

4275 Burnham Ave Ste 230
Las Vegas, NV 89119-5400

Mailing address

390 Otsego CT
Henderson, NV 89012-4862

Other practice location 1

825 N Gibson Rd Ste 301
Henderson, NV 89011-1708
Phone (702) 965-0996

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
I20180621000976 NV Practitioner - Neurology 1951620483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1621 E Flamingo Rd
Suite 16a
Las Vegas, NV 89119-5276
Phone (702) 956-0996

Hospital & facility affiliations

  • Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045
  • Saint Rose Dominican Hospitals - San Martin Campus Hospital, Las Vegas, NV, CCN 290053

Merit-based Incentive Payment System (MIPS)

Final score
64.77 of 100Reported as individual
Quality
11.67
Improvement activities
40
Cost
74.47

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Clinics of Nevada LLC Neurology CurrentSince Oct 1, 2018 Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

825 N Gibson Rd
Ste 301
Henderson, NV 89011
Phone (702) 763-2002

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

4275 Burnham Ave
Ste 230
Las Vegas, NV 89119
Phone (702) 448-5578

1621 E Flamingo Rd
Ste 16A
Las Vegas, NV 89119
Phone (702) 478-9971

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1669883534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 OTSEGO CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890124862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 BURNHAM AVE STE 230",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195400",
            "telephone_number": "702-956-0996",
            "fax_number": "702-965-2216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 N Gibson Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890111708",
            "country_code": "US",
            "telephone_number": "702-965-0996",
            "fax_number": "702-965-2216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARIQ",
        "first_name": "ABDUL",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-14",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NV",
            "license": "DO2378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.