Individual provider Active NPI

Michelle D Conger, DO

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1730152703
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
762 Issued in NV
Practice address
4750 W Oakey Blvd
Las Vegas, NV 89102-1535
Phone
(702) 877-5199
Fax
(702) 984-5184
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 762 NV Primary

Addresses

Primary practice location

4750 W Oakey Blvd
Las Vegas, NV 89102-1535

Mailing address

P.O. Box 25645
Suite 2
Las Vegas, NV 89119
Phone (702) 877-5199

Other identifiers 2

IdentifierTypeStateIssuer
V113510OtherNVMEDICARE SMA
002019697MedicaidNV

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040507001059 NV Practitioner - Family Practice 3779572557 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1986
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)

2845 Siena Heights Dr
Henderson, NV 89052-4153
Phone (702) 579-3253

4750 W Oakey Blvd
Las Vegas, NV 89102-1535
Phone (702) 579-3253

4835 S Durango Dr
Las Vegas, NV 89147-8171
Phone (702) 579-3253

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group Rhodes P C Current Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Jun 10, 2019 Accepting new patients
Southwest Medical Associates, Inc CurrentSince May 2, 2016 Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients

Locations

4835 S Durango Dr
Las Vegas, NV 89147
Phone (702) 876-0534

4750 W Oakey Blvd
Ste 2A
Las Vegas, NV 89102

4750 W Oakey Blvd
Las Vegas, NV 89102
Phone (702) 724-8877

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

Interoperability endpoints

  • Direct secure messaging: mconger119390@westdirect.optum.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1730152703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 25645",
            "address_2": "SUITE 2",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89119",
            "telephone_number": "702-877-5199",
            "fax_number": "702-984-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 W OAKEY BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021535",
            "telephone_number": "702-877-5199",
            "fax_number": "702-984-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONGER",
        "first_name": "MICHELLE",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SMA",
            "identifier": "V113510",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002019697",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.