NPIMap

Individual provider Active NPI

Roehl Pena, MD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1770520306
Registry record updated Jun 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9935 Issued in NV
Practice address
7280 W Azure Dr Ste 130
Las Vegas, NV 89130
Phone
(702) 309-3360
Fax
(702) 309-3370
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9935 NV Primary

Addresses

Primary practice location

7280 W Azure Dr Ste 130
Las Vegas, NV 89130

Mailing address

2345 E Prater Way Ste 207
Sparks, NV 89434-9634
Phone (702) 309-3360

Other identifiers 1

IdentifierTypeStateIssuer
1770520306MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040525001145 NV Practitioner - Internal Medicine 3678554821 Reassigns benefits to 1 organization
Practice locations: Las Vegas, NV

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Las Vegas Medical Group LLCGroup PAC ID 6800118522, 51 clinicians

Practice addresses (Care Compare)

1389 Galleria Dr
Suite 100
Henderson, NV 89014-6686
Phone (725) 333-8400

6850 N Durango Dr
Suite 208
Las Vegas, NV 89149-4596
Phone (702) 835-9870

Hospital & facility affiliations

  • Valley Health at Home by Bayada Home health agency, Las Vegas, NV, CCN 297106
  • Lorian Health Home health agency, Las Vegas, NV, CCN 297099
  • Centennial Hills Hospital Medical Center Hospital, Las Vegas, NV, CCN 290054

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Las Vegas Medical Group LLC Internal Medicine CurrentSince Jun 4, 2018 Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Desert View Regional Medical Center Holdings, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Roehl T Pena MD Internal Medicine PastSince Jan 27, 2004 Accepting new patients
Dignity Health Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
Henderson Hospital Past Accepting new patients
North Vista Hospital LLC Past Accepting new patients

Locations

1389 Galleria Dr
Ste 100
Henderson, NV 89014
Phone (725) 333-8400

7280 W Azure Dr
Ste 130
Las Vegas, NV 89130
Phone (702) 309-3360

6850 N Durango Dr
Ste 208
Las Vegas, NV 89149
Phone (702) 835-9870

2345 E Prater Way
Ste 207
Sparks, NV 89434
Phone (775) 352-5301

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 5

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1770520306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 E PRATER WAY STE 207",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894349634",
            "telephone_number": "702-309-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7280 W AZURE DR STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89130",
            "telephone_number": "702-309-3360",
            "fax_number": "702-309-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "ROEHL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "9935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770520306",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.