Individual provider Active NPI

Angel Louise Wenger, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1811267909
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0473 Issued in NV
Practice address
2701 N Tenaya Way Ste 290
Las Vegas, NV 89128-1406
Phone
(702) 420-2163
Fax
(702) 420-2930
NPI assigned
Jan 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1319 NV
Physician Assistant 363A00000X PA0473 NV Primary

Addresses

Primary practice location

2701 N Tenaya Way Ste 290
Las Vegas, NV 89128-1406

Mailing address

2701 N Tenaya Way Ste 290
Las Vegas, NV 89128-1406
Phone (702) 420-2163

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120214000739 NV Practitioner - Physician Assistant 7315105723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leavitt Medical Associates of Nevada PCGroup PAC ID 0648492181, 4 clinicians

Practice addresses (Care Compare)

861 Coronado Ctr Dr
Suite 100
Henderson, NV 89052-3992
Phone (702) 257-7546

Merit-based Incentive Payment System (MIPS)

Final score
86.52 of 100Reported as group
Quality
89.02
Improvement activities
40
Cost
69.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0473NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
La Laser Center, PC, a Professional Medical Corporation PastSince Apr 24, 2026 Accepting new patients
Vegas Vascular Specialists PLLC PastSince May 22, 2022 Accepting new patients

Organizations & group practices 4

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": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1811267909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 N TENAYA WAY STE 290",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281406",
            "telephone_number": "702-420-2163",
            "fax_number": "702-420-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 N TENAYA WAY STE 290",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891281406",
            "telephone_number": "702-420-2163",
            "fax_number": "702-420-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGER",
        "first_name": "ANGEL",
        "middle_name": "LOUISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1319",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA0473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.