Active NPI
Angela Stefan, MD
- Pediatrics Physician
- North Las Vegas, NV
National Provider Identifier
1720297641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 13260
- Practice address
- 2290 McDaniel St Ste 1B
North Las Vegas, NV 89030-6329 - Phone
- (702) 649-1980
- Fax
- (702) 642-2930
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 13260 | NV | Primary |
Addresses
Primary practice location
2290 McDaniel St Ste 1B
North Las Vegas, NV 89030-6329
Mailing address
2290 McDaniel St Ste 1B
North Las Vegas, NV 89030-6329
Phone (702) 649-1980
Other practice location 1
1905 McDaniel St
Suite 102
North Las Vegas, NV 89030-7169
Phone (702) 649-1980
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810000958 | Medicaid | WV | |
| 1720297641 | Medicaid | NV | |
| 03094048 | Medicaid | NY | |
| 13260 | Other | NV | NV MEDICAL LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13260 | NV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546560000000",
"number": "1720297641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2290 MCDANIEL ST STE 1B",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890306329",
"telephone_number": "702-649-1980",
"fax_number": "702-642-2930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2290 MCDANIEL ST STE 1B",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890306329",
"telephone_number": "702-649-1980",
"fax_number": "702-642-2930"
}
],
"practiceLocations": [
{
"address_1": "1905 McDaniel St",
"address_2": "Suite 102",
"address_purpose": "LOCATION",
"city": "North Las Vegas",
"state": "NV",
"postal_code": "890307169",
"country_code": "US",
"telephone_number": "702-649-1980",
"fax_number": "702-642-2930",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEFAN",
"first_name": "ANGELA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2019-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NV",
"license": "13260",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810000958",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1720297641",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03094048",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NV MEDICAL LICENSE",
"identifier": "13260",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.