Organization Active NPI

Prime Care Medical Services, Inc.

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1740446673
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9214 Issued in NV
Legal business name
PRIME CARE MEDICAL SERVICES, INC.
Practice address
1641 E Flamingo Rd Ste 11
Las Vegas, NV 89119-5257
Phone
(702) 737-9520
Fax
(702) 737-9522
NPI assigned
Jul 30, 2008
Last updated
Oct 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Authorized official

Name
Mr. Romualdo A Aragon Jr., M.D.
Title
President
Phone
(702) 737-9520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 9214 NV Primary

Addresses

Primary practice location

1641 E Flamingo Rd Ste 11
Las Vegas, NV 89119-5257

Mailing address

1641 E Flamingo Rd Ste 11
Las Vegas, NV 89119-5257
Phone (702) 737-9520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111020000220 NV Part B Supplier - Clinic/Group Practice 4981876711 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D0974642Prime Care Medical Services Inc1641 E Flamingo Rd Ste 11, Las Vegas, NV 89119Certificate of waiverFeb 23, 2028

National Provider Directory

National Provider Directory

Locations

3343 S Eastern Ave
Las Vegas, NV 89169
Phone (702) 474-2460

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1740446673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 E FLAMINGO RD STE 11",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195257",
            "telephone_number": "702-737-9520",
            "fax_number": "702-737-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 E FLAMINGO RD STE 11",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195257",
            "telephone_number": "702-737-9520",
            "fax_number": "702-737-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE MEDICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-30",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "ARAGON JR.",
        "authorized_official_first_name": "ROMUALDO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-737-9520",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "9214",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.