Active NPI
Ethan Milton Cruvant, MD
- General Practice Physician
- Las Vegas, NV
National Provider Identifier
1740287192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 5854
- Practice address
- 8205 W. Warm Springs Rd.
Suite 110
Las Vegas, NV 89113 - Phone
- (702) 735-8734
- Fax
- (702) 735-2726
- NPI assigned
- Jun 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 5854 | NV | Primary |
Addresses
Primary practice location
8205 W. Warm Springs Rd.
Suite 110
Las Vegas, NV 89113
Mailing address
8205 W. Warm Springs Rd.
Suite 110
Las Vegas, NV 89113-3612
Phone (702) 735-8734
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002019008 | Medicaid | NV | |
| 110227382 | Other | RAILROAD MEDICARE | |
| 880344806A002 | Other | TRIWEST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edelstein Medical Group, PLLC | Past | Accepting new patients | |
| Carolyn a Cruvant, MD, PC | Past | Accepting new patients |
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 and National Provider Directory roles.
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-
- Internal Medicine Physician
- Las Vegas, NV
- NPI 1760786552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308009600000",
"number": "1740287192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8205 W. WARM SPRINGS RD.",
"address_2": "SUITE 110",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891133612",
"telephone_number": "702-735-8734",
"fax_number": "702-735-2726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8205 W. WARM SPRINGS RD.",
"address_2": "SUITE 110",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89113",
"telephone_number": "702-735-8734",
"fax_number": "702-735-2726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUVANT",
"first_name": "ETHAN",
"middle_name": "MILTON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-30",
"last_updated": "2011-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NV",
"license": "5854",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002019008",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110227382",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST",
"identifier": "880344806A002",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.