Individual provider Active NPI

Robert Merrell, MD

  • Nephrology Physician
  • Boulder City, NV
National Provider Identifier
1699765586
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
5932 Issued in NV
Practice address
379 Avenue I
Boulder City, NV 89005-2623
Phone
(702) 592-6136
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 5932 NV Primary

Addresses

Primary practice location

379 Avenue I
Boulder City, NV 89005-2623

Mailing address

379 Avenue I
Boulder City, NV 89005-2623

Other identifiers 1

IdentifierTypeStateIssuer
2002659MedicaidNV

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
I20100428000408 NV Practitioner - NephrologyPractitioner - Internal Medicine 2567475833 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5932NVMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology & Endocrine Associates Inc Nephrology CurrentSince Jul 1, 1966 Accepting new patients
Nephrology & Endocrine Associates Inc CurrentSince Jul 1, 1966 Accepting new patients
Total Renal Care Inc PastSince Oct 22, 2007 Accepting new patients

Locations

500 S Rancho Dr
Ste 12
Las Vegas, NV 89106
Phone (702) 877-1877

8775 Deer Springs Way
Las Vegas, NV 89149
Phone (702) 395-2488

1294 S Jones Blvd
Las Vegas, NV 89146
Phone (702) 877-1877

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1699765586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 AVENUE I",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890052623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 AVENUE I",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890052623",
            "telephone_number": "702-592-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRELL",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NV",
            "license": "5932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2002659",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder City, NV

Sources for this page

Verify at the official NPI Registry.