Individual provider Active NPI

Maria Edna Landero, M.D.

  • Family Medicine Physician
  • Henderson, NV
National Provider Identifier
1790118115
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23200 Issued in NV
Practice address
2845 Siena Heights Dr
Henderson, NV 89052-4153
Phone
(702) 877-5199
NPI assigned
Aug 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 29399 PR
Family Medicine Physician 207Q00000X Q9181 TX
Family Medicine Physician 207Q00000X 23200 NV Primary

Addresses

Primary practice location

2845 Siena Heights Dr
Henderson, NV 89052-4153

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5088

Other practice location 1

601 Fall Creek Hwy
Granbury, TX 76049-7960
Phone (817) 326-3900

Other identifiers 1

IdentifierTypeStateIssuer
362366201MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address maria.landero.1@1293.direct.athenahealth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230221001320 NV Practitioner - Family Practice 5698062438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

2845 Siena Heights Dr
Henderson, NV 89052-4153
Phone (702) 579-3253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29399PRMDFamily Medicine Physician
Q9181TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group II Rhodes P C CurrentSince Feb 1, 2023 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Feb 1, 2023 Accepting new patients
Desert Springs Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Granbury Hospital Corporation Past Accepting new patients

Locations

2845 Siena Heights Dr
Henderson, NV 89052
Phone (702) 617-1227

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

Interoperability endpoints

  • Direct secure messaging: maria.landero.1@1293.direct.athenahealth.com
  • Direct secure messaging: mlandero119404@westdirect.optum.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1790118115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 SIENA HEIGHTS DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524153",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Fall Creek Hwy",
            "address_purpose": "LOCATION",
            "city": "Granbury",
            "state": "TX",
            "postal_code": "760497960",
            "country_code": "US",
            "telephone_number": "817-326-3900",
            "fax_number": "817-578-8903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDERO",
        "first_name": "MARIA",
        "middle_name": "EDNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-21",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "29399",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q9181",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "23200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362366201",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maria.landero.1@1293.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "601 Fall Creek Hwy",
            "city": "Granbury",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760497960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.