Individual provider Active NPI

Dristhi S Ragoonanan, M.D/M.B.B.S

  • Pediatric Hematology & Oncology Physician
  • Las Vegas, NV
National Provider Identifier
1831573005
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
26156 Issued in NV
Practice address
1 Breakthrough Way
Las Vegas, NV 89135-3011
Phone
(702) 732-1493
Fax
(702) 732-1080
NPI assigned
Jul 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X T7010 TX
Pediatric Hematology & Oncology Physician 2080P0207X 26156 NV Primary

Addresses

Primary practice location

1 Breakthrough Way
Las Vegas, NV 89135-3011

Mailing address

10170 W Tropicana Ave # 156-252
Las Vegas, NV 89147-8465
Phone (702) 732-1493

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
I20240926001492 NV Practitioner - Hematology/OncologyPractitioner - Pediatric Medicine 6901288406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Pediatric Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance for Childhood DiseasesGroup PAC ID 9739303298, 13 clinicians

Practice addresses (Care Compare)

1 Breakthrough Way
Las Vegas, NV 89135-3011
Phone (702) 732-1493

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance for Childhood Diseases CurrentSince Sep 30, 2024 Accepting new patients
Alliance for Childhood Diseases Pediatric Hematology-Oncology CurrentSince Sep 30, 2024 Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients

Locations

1 Breakthrough Way
Ste 300
Las Vegas, NV 89135

10170 W Tropicana Ave
#156252
Las Vegas, NV 89147

1 Breakthrough Way
Las Vegas, NV 89135
Phone (702) 822-5433

Organizations & group practices 3

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": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1831573005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10170 W TROPICANA AVE # 156-252",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478465",
            "telephone_number": "702-732-1493",
            "fax_number": "702-732-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BREAKTHROUGH WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891353011",
            "telephone_number": "702-732-1493",
            "fax_number": "702-732-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGOONANAN",
        "first_name": "DRISTHI",
        "middle_name": "S",
        "credential": "M.D/M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "TX",
            "license": "T7010",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NV",
            "license": "26156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.