Individual provider Active NPI

Cameron I Earl, M.D.

  • Plastic Surgery Physician
  • Las Vegas, NV
National Provider Identifier
1740269703
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
45965 Issued in MN
Practice address
653 N Town Center Dr
Suite 108
Las Vegas, NV 89144-0514
Phone
(702) 939-3436
Fax
(702) 939-3437
NPI assigned
Jan 10, 2006
Last updated
May 19, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 45965 MN Primary

Addresses

Primary practice location

653 N Town Center Dr
Suite 108
Las Vegas, NV 89144-0514

Mailing address

653 N Town Center Dr
Suite 108
Las Vegas, NV 89144-0514
Phone (702) 939-3436

Other identifiers 2

IdentifierTypeStateIssuer
764475200MedicaidMN
V10447OtherNVMEDICARE GROUP NUMBER

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
I20070913000108 NV Practitioner - Plastic and Reconstructive Surgery 5799759866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Utah School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

653 N Town Ctr Dr
Suite 108
Las Vegas, NV 89144-0515
Phone (702) 939-3436

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy56
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45965MNMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Earl Plastic Surgery, P.C. Plastic Surgery CurrentSince Aug 1, 2007 Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

653 N Town Center Dr
Ste 108
Las Vegas, NV 89144
Phone (702) 254-0500

Organizations & group practices 2

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 2

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242691200000",
    "number": "1740269703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR",
            "address_2": "SUITE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440514",
            "telephone_number": "702-939-3436",
            "fax_number": "702-939-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR",
            "address_2": "SUITE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440514",
            "telephone_number": "702-939-3436",
            "fax_number": "702-939-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARL",
        "first_name": "CAMERON",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2009-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MN",
            "license": "45965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "764475200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "V10447",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.