Individual provider Active NPI

Michael Avila-Cabral, PA-C

  • Medical Physician Assistant
  • North Las Vegas, NV
National Provider Identifier
1689903155
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA2506 Issued in NV
Practice address
1550 W Craig Rd
North Las Vegas, NV 89032-0327
Phone
(702) 777-3615
NPI assigned
Dec 13, 2009
Last updated
Jun 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA20684 CA
Medical Physician Assistant 363AM0700X PA2506 NV Primary

Addresses

Primary practice location

1550 W Craig Rd
North Las Vegas, NV 89032-0327

Mailing address

2100 Powell St
Suite 900
Emeryville, CA 94608-1826
Phone (510) 350-2698

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211117000230 NV Practitioner - Physician Assistant 5092731125 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Nevada LLCGroup PAC ID 7012137037, 106 clinicians

Practice addresses (Care Compare)

2202 W Craig Rd
North Las Vegas, NV 89032-3018
Phone (702) 826-3200

3020 W Ann Rd
North Las Vegas, NV 89031-7259
Phone (702) 701-9501

4575 W Charleston Blvd
Suite a
Las Vegas, NV 89102-1501
Phone (702) 877-8777

5570 Camino Al Norte
Suite 1
North Las Vegas, NV 89031-0809
Phone (702) 657-0756

6440 Centennial Ctr Blvd
Suite 110
Las Vegas, NV 89149-4797
Phone (702) 901-8320

8300 W Cheyenne Ave
Suite 106
Las Vegas, NV 89129-2177
Phone (702) 656-0911

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20684CAMDPediatric Occupational Therapist
PA20684CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity-Nevada Medical Services Koury & Partners PC CurrentSince Jul 9, 2024 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

102 E Lake Mead Pkwy
Henderson, NV 89015
Phone (701) 564-2622

Organizations & group practices 3

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 5

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": "1260662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1689903155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2698",
            "fax_number": "510-879-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 W CRAIG RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890320327",
            "telephone_number": "702-777-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA-CABRAL",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-13",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20684",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA2506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.