Individual provider Active NPI

Diane M Levin, DO

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1689906703
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
763 Issued in NV
Practice address
4880 Wynn Rd
Las Vegas, NV 89103-5406
Phone
(702) 871-5005
Fax
(702) 671-6883
NPI assigned
Feb 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 763 NV Primary

Addresses

Primary practice location

4880 Wynn Rd
Las Vegas, NV 89103-5406

Mailing address

PO Box 98978
Las Vegas, NV 89193-8978
Phone (702) 216-3346

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110505000655 NV Practitioner - Family Practice 3678758679

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
763NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Medical Group Coats LTD Family Medicine Current Accepting new patients
Seven Hills Family Practice LLC Family Medicine Past Accepting new patients
Intermountain Medical Holdings Nevada Inc Family Medicine Past Accepting new patients

Locations

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1689906703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98978",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891938978",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 WYNN RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891035406",
            "telephone_number": "702-871-5005",
            "fax_number": "702-671-6883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVIN",
        "first_name": "DIANE",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-01",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.