Individual provider Active NPI

Esau Omar Moreno Marquez

  • Attendant Care Provider
  • Las Vegas, NV
National Provider Identifier
1700628575
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
Practice address
2881 S Valley View Blvd Ste 6
Las Vegas, NV 89102-0171
Phone
(702) 253-1031
Fax
(702) 253-9474
NPI assigned
Jun 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chore Provider 372500000X
Attendant Care Provider 3747A0650X Primary

Addresses

Primary practice location

2881 S Valley View Blvd Ste 6
Las Vegas, NV 89102-0171

Mailing address

2881 S Valley View Blvd Ste 6
Las Vegas, NV 89102-0171
Phone (702) 253-1031

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

NPI Registry JSON

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1700628575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2881 S VALLEY VIEW BLVD STE 6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891020171",
            "telephone_number": "702-253-1031",
            "fax_number": "702-253-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2881 S VALLEY VIEW BLVD STE 6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891020171",
            "telephone_number": "702-253-1031",
            "fax_number": "702-253-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "ESAU",
        "middle_name": "OMAR MORENO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.