Organization Active NPI

Reza Vaghefi Prof Corp

  • Infectious Disease Physician
  • Henderson, NV
National Provider Identifier
1780350009
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
REZA VAGHEFI PROF CORP
Practice address
2900 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-5014
Phone
(702) 445-4554
NPI assigned
Aug 17, 2021
Last updated
Aug 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Authorized official

Name
Reza Vaghefi Hosseini, MDNPI 1184868093
Title
Provider
Phone
(702) 487-7055

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X NU Primary

Addresses

Primary practice location

2900 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-5014

Mailing address

10577 Acacia Park PL
Las Vegas, NV 89135-1243

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210920002544 NV Part B Supplier - Clinic/Group Practice 2769889666 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

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": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1780350009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10577 ACACIA PARK PL",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W HORIZON RIDGE PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525014",
            "telephone_number": "702-445-4554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REZA VAGHEFI PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "VAGHEFI HOSSEINI",
        "authorized_official_first_name": "REZA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "702-487-7055",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.