NPIMap

Organization Active NPI

Desert Shadow Endocopy Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1801908843
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
4493ASC-0 Issued in NV
Legal business name
DESERT SHADOW ENDOCOPY CENTER, LLC
Practice address
4275 Burnham Ave
Suite #101
Las Vegas, NV 89119-5488
Phone
(702) 220-5601
Fax
(702) 227-3076
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Authorized official

Name
Dipak Desai, M.D.
Title
Director
Phone
(702) 220-5601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 4493ASC-0 NV Primary

Addresses

Primary practice location

4275 Burnham Ave
Suite #101
Las Vegas, NV 89119-5488

Mailing address

PO Box 35140
Las Vegas, NV 89133-5140
Phone (702) 220-5601

Other identifiers 1

IdentifierTypeStateIssuer
100510771MedicaidNV

Other names 1

  • Desert Shadow Endoscopy Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1801908843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335140",
            "telephone_number": "702-220-5601",
            "fax_number": "702-227-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 BURNHAM AVE",
            "address_2": "SUITE #101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195488",
            "telephone_number": "702-220-5601",
            "fax_number": "702-227-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT SHADOW ENDOCOPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "DIPAK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "702-220-5601",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NV",
            "license": "4493ASC-0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100510771",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Shadow Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.