NPIMap

Organization Active NPI

Klinic Medical PLLC

  • General Practice Physician
  • Las Vegas, NV
National Provider Identifier
1740980630
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
KLINIC MEDICAL PLLC
Practice address
1930 Village Center Cir # 3-6136
Las Vegas, NV 89134-6299
Phone
(206) 495-0724
Fax
(877) 823-3570
NPI assigned
Mar 8, 2023
Last updated
Apr 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Authorized official

Name
Aneel Ursani, MDNPI 1982085676
Title
President
Phone
(206) 495-0724

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1930 Village Center Cir # 3-6136
Las Vegas, NV 89134-6299

Mailing address

1201 2ND Ave Ste 900
Seattle, WA 98101-3020

Other practice location 1

780 Lynnhaven Pkwy Ste 400
Virginia Beach, VA 23452-7332
Phone (206) 495-0724

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231114001201 VA Part B Supplier - Clinic/Group Practice 1456716976 Receives reassigned benefits from 5 practitioners
Practice locations: Virginia Beach, VA

National Provider Directory

National Provider Directory

Locations

7022 W 10th St
Ste A
Indianapolis, IN 46214
Phone (317) 279-5045

1930 Village Center Cir
#36136
Las Vegas, NV 89134
Phone (206) 495-0724

1987 Henderson Rd
Ste 619
Columbus, OH 43220

1989 Henderson Rd
Ste 621
Columbus, OH 43220

1991 Henderson Rd
Ste 623
Columbus, OH 43220

1993 Henderson Rd
Ste 625
Columbus, OH 43220

1995 Henderson Rd Ste 627
Columbus, OH 43220

1800 John F Kennedy Blvd
Ste 300
Philadelphia, PA 19103

1202 2nd Ave
Ste 900
Seattle, WA 98101

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1740980630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 2ND AVE STE 900",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981013020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 VILLAGE CENTER CIR # 3-6136",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346299",
            "telephone_number": "206-495-0724",
            "fax_number": "877-823-3570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 Lynnhaven Pkwy Ste 400",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234527332",
            "country_code": "US",
            "telephone_number": "206-495-0724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KLINIC MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-08",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "URSANI",
        "authorized_official_first_name": "ANEEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-495-0724",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "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 Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.