Individual provider Active NPI

Lauren V Abela, PA-C

  • Medical Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1700869054
Registry record updated Oct 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA753 Issued in NV
Practice address
9975 S Eastern Ave Ste 110
Las Vegas, NV 89183-7950
Phone
(702) 492-7208
Fax
(702) 616-0657
NPI assigned
Nov 21, 2005
Last updated
Oct 13, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA753 NV Primary

Addresses

Primary practice location

9975 S Eastern Ave Ste 110
Las Vegas, NV 89183-7950

Mailing address

9975 S Eastern Ave Ste 110
Las Vegas, NV 89183-7950
Phone (702) 492-7208

Other identifiers 1

IdentifierTypeStateIssuer
1700869054MedicaidNV

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
I20051230000054 NV Practitioner - Physician Assistant 2264454545 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA753NVMDMedical Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507852800000",
    "number": "1700869054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9975 S EASTERN AVE STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891837950",
            "telephone_number": "702-492-7208",
            "fax_number": "702-616-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9975 S EASTERN AVE STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891837950",
            "telephone_number": "702-492-7208",
            "fax_number": "702-616-0657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABELA",
        "first_name": "LAUREN",
        "middle_name": "V",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2017-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700869054",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.