Nithya Devanathan

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Las Vegas, NV

NPI 1801697131 · NPPES record last updated Mar 24, 2025

Key facts

NPI
1801697131
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
2880 N Tenaya Way FL 2
Las Vegas, NV 89128-0618
Phone
(702) 480-8916
NPI assigned
Mar 22, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250626003819 NV Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
8921511650

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

2880 N Tenaya Way FL 2
Las Vegas, NV 89128-0618

Mailing address

2880 N Tenaya Way FL 2
Las Vegas, NV 89128-0618

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Student in an Organized Health Care Education/Training Program in Nevada

Sources for this page

Verify at the official NPI Registry.