Shaun Andersen, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Las Vegas, NV
NPI 1730948043 · NPPES record last updated Mar 18, 2024
Key facts
- NPI
- 1730948043
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 9260 W Sunset Rd Ste 110
Las Vegas, NV 89148-4903 - Phone
- (702) 916-6904
- NPI assigned
- Mar 18, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240710001754 | NV | Order and Referring Only - Anesthesiology |
8325583735 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
9260 W Sunset Rd Ste 110
Las Vegas, NV 89148-4903
Mailing address
9260 W Sunset Rd Ste 110
Las Vegas, NV 89148-4903
Phone (702) 916-6904
Other providers in Las Vegas, NV
- Allison Andersen
- David A Andersen
- Jennifer Andersen
- Kristy Lee Andersen
- Madeline Andersen
- Anderson Audiology PC
- Terri Anderson Brooks
- Anderson Chiropractic
- Kayce Audin Anderson Farmer
- Anderson Hu DO PC
All providers in Las Vegas, NV · Student in an Organized Health Care Education/Training Program in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.