NPIMap

Individual provider Active NPI

Dijana Jefic, MD

  • Nephrology Physician
  • Henderson, NV
National Provider Identifier
1730134057
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
13545 Issued in NV
Practice address
229 N Pecos Rd
Ste 120
Henderson, NV 89074-7364
Phone
(702) 256-3637
Fax
(702) 256-3307
NPI assigned
May 24, 2006
Last updated
Feb 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 13545 NV Primary

Addresses

Primary practice location

229 N Pecos Rd
Ste 120
Henderson, NV 89074-7364

Mailing address

861 Coronado Center Dr
Ste 211
Henderson, NV 89052-3992
Phone (702) 818-9246

Other identifiers 1

IdentifierTypeStateIssuer
1730134057MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101214000091 NV Practitioner - NephrologyPractitioner - Internal Medicine 2567475528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Las Vegas Kidney and Hypertension Specialists LLCGroup PAC ID 6507099132, 6 clinicians

Practice addresses (Care Compare)

2075 E Flamingo Rd
Desert Springs Hospital
Las Vegas, NV 89119-5188
Phone (702) 733-8800

229 N Pecos Rd
Suite 120
Henderson, NV 89074-7364
Phone (702) 629-7510

3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Phone (702) 616-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Las Vegas Kidney & Hypertension Specialists LLC Nephrology CurrentSince Sep 1, 2013 Accepting new patients
Metro Detroit Kidney Doctors, P.C. Nephrology Past Accepting new patients
Dignity Health Past Accepting new patients
North Vista Hospital LLC Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
Kantor Nephrology Consultants, LTD Nephrology PastSince Dec 6, 2012 Accepting new patients
Piceno Kidney & Hypertension Specialists, LLC Nephrology Past Accepting new patients

Locations

229 N Pecos Rd
Ste 120
Henderson, NV 89074
Phone (631) 793-4531

861 Coronado Center Dr
Ste 211
Henderson, NV 89052
Phone (702) 800-4530

2075 E Flamingo Rd
Las Vegas, NV 89119
Phone (702) 369-7613

Organizations & group practices 8

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1730134057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 CORONADO CENTER DR",
            "address_2": "STE 211",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523992",
            "telephone_number": "702-818-9246",
            "fax_number": "702-492-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 N PECOS RD",
            "address_2": "STE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747364",
            "telephone_number": "702-256-3637",
            "fax_number": "702-256-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFIC",
        "first_name": "DIJANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NV",
            "license": "13545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730134057",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.