Javier Ismael Garduno, M.D.

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

15440 Issued in NV

Practice address

4750 W Oakey Blvd Ste 3a
Las Vegas, NV 89102-1535

Phone

(702) 877-5319

Fax

(702) 259-0128

NPI assigned

Dec 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Ismael Xavier Garduno Other name

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

Specialty

Pain Management

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgarduno117990@westdirect.optum.com

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.

• Optum Medical Group II Rhodes P C

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1790329407
  Medicare reassignment Care Compare group NPD
• Southwest Medical Associates, Inc

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1659346005
  Medicare reassignment NPD
• Optum Medical Group Rhodes P C

  • Anesthesiology Physician
  • Las Vegas, NV
  • NPI 1770556037
  NPD

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1720141120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5199",
            "fax_number": "702-259-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 W OAKEY BLVD STE 3A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021535",
            "telephone_number": "702-877-5319",
            "fax_number": "702-259-0128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 W Charleston Blvd",
            "address_2": "Ste 150",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891022149",
            "country_code": "US",
            "telephone_number": "702-877-5319",
            "fax_number": "702-259-0128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDUNO",
        "first_name": "JAVIER",
        "middle_name": "ISMAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NV",
            "license": "15440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720141120",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ISMAEL",
            "last_name": "GARDUNO",
            "middle_name": "XAVIER",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Timothy Warren Gardner, PA-C
• Todd L Gardner, D.C.
• Tonya C Gardner
• Monica Garduno-Valladolid
• Clementina Garduno
• Arnel Garduque
• Kristian Garello
• Thomas Peter Garetto, MD
• Maria Garey
• Brendan Garfias-Escalera

• Pain Medicine (Anesthesiology) Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pain Medicine (Anesthesiology) Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.