Active NPI
Robert Lee Marcus
- Behavior Analyst
- North Las Vegas, NV
National Provider Identifier
1679901094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- NV20121663543
- Practice address
- 1200 Helen Ave
North Las Vegas, NV 89030-3721 - Phone
- (702) 636-9229
- Fax
- (702) 636-9229
- NPI assigned
- Oct 22, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | NV20121663543 | NV | Primary |
Addresses
Primary practice location
1200 Helen Ave
North Las Vegas, NV 89030-3721
Mailing address
1200 Helen Ave
North Las Vegas, NV 89030-3721
Phone (702) 636-9229
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103K00000X | Medicaid | NV |
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
| License | State | Type | Specialty |
|---|---|---|---|
| NV20121663543 | NV | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eisteam Communuty Wellness Centers | Past | Accepting new patients | |
| Eisteam Community Wellness Centers | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- North Las Vegas, NV
- NPI 1255774915
-
- Community/Behavioral Health Agency
- North Las Vegas, NV
- NPI 1619310646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1382400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382400000000",
"number": "1679901094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 HELEN AVE",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890303721",
"telephone_number": "702-636-9229",
"fax_number": "702-636-9229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 HELEN AVE",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890303721",
"telephone_number": "702-636-9229",
"fax_number": "702-636-9229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCUS",
"first_name": "ROBERT",
"middle_name": "LEE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-22",
"last_updated": "2013-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NV",
"license": "NV20121663543",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103K00000X",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.