Individual provider Active NPI

John A Seibel, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Las Vegas, NV
National Provider Identifier
1730182148
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
3951 Issued in NV
Practice address
4750 W Oakey Blvd
Ste 4C
Las Vegas, NV 89102-1535
Phone
(702) 877-5306
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 72225 NM
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 3951 NV Primary

Addresses

Primary practice location

4750 W Oakey Blvd
Ste 4C
Las Vegas, NV 89102-1535

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5199

Other identifiers 2

IdentifierTypeStateIssuer
24919MedicaidNM
1730182148MedicaidNV

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
I20161005000954 NV Practitioner - EndocrinologyPractitioner - Internal Medicine 8426245317 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3951NVMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group Rhodes P C Current Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Jun 5, 2019 Accepting new patients
Southwest Medical Associates, Inc CurrentSince Sep 25, 2016 Accepting new patients
Corazon Family Health PC PastSince Apr 1, 2013 Accepting new patients
Santa Fe Medical Group, LLC Past Accepting new patients

Locations

4750 W Oakey Blvd
Ste 4C
Las Vegas, NV 89102
Phone (702) 877-5306

2300 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 724-8787

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

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

Organizations & group practices 5

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1730182148",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 W OAKEY BLVD",
            "address_2": "STE 4C",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021535",
            "telephone_number": "702-877-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIBEL",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NM",
            "license": "72225",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NV",
            "license": "3951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24919",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730182148",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.