NPIMap

Individual provider Active NPI

Mit P Dave, M.D.

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1679816987
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16706 Issued in NV
Practice address
2716 N Tenaya Way FL 4
Las Vegas, NV 89128-0424
Phone
(702) 877-8600
Fax
(702) 242-7944
NPI assigned
Apr 4, 2013
Last updated
Nov 1, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 16706 NV Primary
Hospitalist Physician 208M00000X 16706 NV

Addresses

Primary practice location

2716 N Tenaya Way FL 4
Las Vegas, NV 89128-0424

Mailing address

PO Box 15645
Apt. 4
Las Vegas, NV 89114-5645
Phone (702) 877-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161004001322 NV Practitioner - Family Practice 4587952718 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Physicians Kumar PLLCGroup PAC ID 3577893965, 37 clinicians

Practice addresses (Care Compare)

2865 Siena Heights Dr
Suite 140
Henderson, NV 89052-4168
Phone (702) 202-0534

6090 S Fort Apache Rd
Suite 140
Las Vegas, NV 89148-5618
Phone (702) 202-0534

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16706NVMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Physicians (Kumar) PLLC Family Medicine CurrentSince Nov 1, 2022 Accepting new patients
Platinum Hospitalists LLP Family Medicine CurrentSince Jun 19, 2017 Accepting new patients
Southwest Medical Associates, Inc CurrentSince Sep 19, 2016 Accepting new patients
Platinum Hospitalists LLP Family Medicine CurrentSince Jun 19, 2017 Accepting new patients
Reliant Physicians (Kumar) PLLC PastSince Sep 24, 2023 Accepting new patients
Yate Holdings, LLC Past Accepting new patients

Locations

10624 S Eastern Ave
#A955
Henderson, NV 89052
Phone (702) 407-7700

2865 Siena Heights Dr
Ste 140
Henderson, NV 89052
Phone (702) 202-0534

1140 N Town Center Dr
Ste 100
Las Vegas, NV 89144
Phone (702) 202-2060

1180 N Town Center Dr
Ste 100
Las Vegas, NV 89144
Phone (702) 202-2060

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

2704 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 243-8500

6090 S Fort Apache Rd
Ste 140
Las Vegas, NV 89148
Phone (702) 202-0534

7495 W Azure Dr
Ste 209
Las Vegas, NV 89130
Phone (702) 327-6653

Organizations & group practices 6

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 4

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": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1679816987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "address_2": "APT. 4",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "702-877-8600",
            "fax_number": "702-242-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 N TENAYA WAY FL 4",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280424",
            "telephone_number": "702-877-8600",
            "fax_number": "702-242-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "MIT",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-04",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "16706",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "16706",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.