Individual provider Active NPI

J Randall Feikes, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Las Vegas, NV
National Provider Identifier
1790811396
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
8749 Issued in NV
Practice address
5320 S Rainbow Blvd
Ste 282
Las Vegas, NV 89118-1895
Phone
(702) 737-3808
Fax
(702) 737-0154
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 8749 NV Primary

Addresses

Primary practice location

5320 S Rainbow Blvd
Ste 282
Las Vegas, NV 89118-1895

Mailing address

5320 S Rainbow Blvd
Ste 282
Las Vegas, NV 89118-1895
Phone (702) 737-3808

Other identifiers 1

IdentifierTypeStateIssuer
20-18050MedicaidNV

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
I20100628000831 NV Practitioner - Cardiac SurgeryPractitioner - General PracticePractitioner - Thoracic SurgeryPractitioner - Vascular Surgery 7618008145

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Surgery Associates Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Oct 1, 2010 Accepting new patients

Organizations & group practices 1

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1790811396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 S RAINBOW BLVD",
            "address_2": "STE 282",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181895",
            "telephone_number": "702-737-3808",
            "fax_number": "702-737-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 S RAINBOW BLVD",
            "address_2": "STE 282",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181895",
            "telephone_number": "702-737-3808",
            "fax_number": "702-737-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEIKES",
        "first_name": "J",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NV",
            "license": "8749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20-18050",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.