Individual provider Active NPI

Clifford Michael Friesen, M.D.

  • Anesthesiology Physician
  • Las Vegas, NV
National Provider Identifier
1689674251
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
5004 Issued in NV
Practice address
7250 Peak Dr Ste 100
Las Vegas, NV 89128-9028
Phone
(702) 386-4700
Fax
(702) 386-4701
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 5004 NV Primary

Addresses

Primary practice location

7250 Peak Dr Ste 100
Las Vegas, NV 89128-9028

Mailing address

3157 N Rainbow Blvd # 518
Las Vegas, NV 89108-4578
Phone (702) 386-4700

Other identifiers 1

IdentifierTypeStateIssuer
100504305MedicaidNV

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
I20040903000019 NV Practitioner - Anesthesiology 9335115187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PBS Anesthesia LLCGroup PAC ID 7911090204, 42 clinicians

Practice addresses (Care Compare)

7250 Peak Dr
Suite 100
Las Vegas, NV 89128-9028
Phone (702) 386-4700

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PBS Anesthesia LLC CurrentSince Aug 1, 2024 Accepting new patients
Fielden Hanson Isaacs Miyada Robison Yeh LTD Anesthesiology PastSince Jun 18, 2023 Accepting new patients

Locations

7250 Peak Dr
Ste 100
Las Vegas, NV 89128
Phone (702) 245-5960

3157 N Rainbow Blvd
Las Vegas, NV 89108

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.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1689674251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3157 N RAINBOW BLVD # 518",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891084578",
            "telephone_number": "702-386-4700",
            "fax_number": "702-386-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 PEAK DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891289028",
            "telephone_number": "702-386-4700",
            "fax_number": "702-386-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIESEN",
        "first_name": "CLIFFORD",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "5004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100504305",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.