Individual provider Active NPI

Roman Fajardo, M.D.

  • Ophthalmology Physician
  • Las Vegas, NV
National Provider Identifier
1831459486
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
16329 Issued in NV
Practice address
2020 Wellness Way Ste 402
Las Vegas, NV 89106-4145
Phone
(702) 485-5000
Fax
(702) 485-5005
NPI assigned
May 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 16329 NV Primary

Addresses

Primary practice location

2020 Wellness Way Ste 402
Las Vegas, NV 89106-4145

Mailing address

50 S Stephanie St Ste 101
Henderson, NV 89012-5731
Phone (702) 202-4776

Other practice location 1

7305 S Pecos Rd Ste 101
Las Vegas, NV 89120-3701
Phone (702) 485-5000

Other practice location 2

10105 Banburry Cross Dr Ste 255
Las Vegas, NV 89144-6648
Phone (702) 485-5000

Other practice location 3

8352 W Warm Springs Rd Ste 130
Las Vegas, NV 89113-3629
Phone (702) 485-5000

Other practice location 4

6850 N Durango Dr Ste 106
Las Vegas, NV 89149-4596
Phone (702) 485-5000

Other identifiers 1

IdentifierTypeStateIssuer
1831459486MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: rfajardo@cepnv-ne.emadirect.md

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1831459486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S STEPHANIE ST STE 101",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890125731",
            "telephone_number": "702-202-4776",
            "fax_number": "702-202-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 WELLNESS WAY STE 402",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064145",
            "telephone_number": "702-485-5000",
            "fax_number": "702-485-5005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7305 S Pecos Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891203701",
            "country_code": "US",
            "telephone_number": "702-485-5000",
            "fax_number": "702-485-5005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10105 Banburry Cross Dr Ste 255",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891446648",
            "country_code": "US",
            "telephone_number": "702-485-5000",
            "fax_number": "702-485-5005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8352 W Warm Springs Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891133629",
            "country_code": "US",
            "telephone_number": "702-485-5000",
            "fax_number": "702-485-5005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6850 N Durango Dr Ste 106",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891494596",
            "country_code": "US",
            "telephone_number": "702-485-5000",
            "fax_number": "702-485-5005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "ROMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-16",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NV",
            "license": "16329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831459486",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 29, 2023; 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.