NPIMap

Organization Active NPI

North Vista Hospital LLC

Doing business as North Vista Hospital

  • General Acute Care Hospital
  • North Las Vegas, NV
National Provider Identifier
1720037799
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
649HOS12 Issued in NV
Legal business name
NORTH VISTA HOSPITAL LLC
Doing business as
North Vista Hospital
Practice address
1409 E Lake Mead Blvd
North Las Vegas, NV 89030-7120
Phone
(702) 649-7711
NPI assigned
May 8, 2006
Last updated
Jun 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Authorized official

Name
Christopher Doan
Title
Managing Associate General Counsel
Phone
(310) 259-4706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 649HOS12 NV Primary

Addresses

Primary practice location

1409 E Lake Mead Blvd
North Las Vegas, NV 89030-7120

Mailing address

1409 E Lake Mead Blvd
North Las Vegas, NV 89030-7120
Phone (702) 649-7711

Other identifiers 17

IdentifierTypeStateIssuer
100502300MedicaidNV
2000051340AMedicaidOK
200327790AMedicaidKS
2900005MedicaidNC
913275900MedicaidFL
304744870MedicaidMI
645868MedicaidAZ
0381966MedicaidOH
48475254MedicaidNM
100502299MedicaidNV
100502301MedicaidNV
1704989MedicaidLA
XHSP33711MedicaidCA
XHSP43711MedicaidCA
752632600MedicaidMI
33224871MedicaidCO
807122600MedicaidIA

Other names 1

  • North Vista Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423001045 NV Part A Provider - Hospital 9436145414 Practice locations: North Las Vegas, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720037799. Details of each certification follow.

Hospital certification: CCN 290005

Legal name
NORTH VISTA HOSPITAL LLC
Doing business as
NORTH VISTA HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 21, 2021
Last certification
Jul 6, 2012
Beds
177
Ownership / control type
Private (not for profit)
Organization structure
LLCProprietary
Incorporated
Jan 22, 2015 in DE
Enrollment address
1409E Lake Mead Blvd
North Las Vegas, NV 89030-7120
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
North Vista HospitalCCN 290005 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Elliott Kay Individual Corporate OfficerChief Financial Officer Mar 1, 2016
W-2 Managing EmployeeChief Financial Officer Mar 1, 2016
Prime Healthcare Services North Vista LLC Organization, Ontario, CA For-profit 5% Or Greater Direct Ownership Interest Jan 22, 2015 100%
Prime Healthcare Services, Inc Organization, Ontario, CA For-profit 5% Or Greater Indirect Ownership Interest Jan 22, 2015 100%
Steven Aleman Individual OtherChief Financial Officer Jun 1, 2020
Christopher Doan Individual Corporate OfficerManaging Associate General Counsel Jan 1, 2020
Prime Healthcare Holdings Inc Organization, Ontario, CA Holding company 5% Or Greater Indirect Ownership Interest Jan 22, 2015 100%
Vincenzo Variale Individual Corporate OfficerChief Executive Officer Jan 22, 2015
W-2 Managing EmployeeAd;Chief Executive Officer Jan 22, 2015

Facilities with the same owner 77

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 77

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

Affiliated clinicians 95

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 95

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656288000000",
    "number": "1720037799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 E LAKE MEAD BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307120",
            "telephone_number": "702-649-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 E LAKE MEAD BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307120",
            "telephone_number": "702-649-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH VISTA HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NV",
            "license": "649HOS12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502300",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000051340A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200327790A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2900005",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "913275900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304744870",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "645868",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0381966",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48475254",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502299",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502301",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1704989",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP33711",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP43711",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "752632600",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33224871",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807122600",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Vista Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.