Individual provider Active NPI

Keith Paolo Maquiling, PTA

  • Physical Therapy Assistant
  • North Las Vegas, NV
National Provider Identifier
1871354464
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A-1720 Issued in NV
Practice address
3870 W Ann Rd
North Las Vegas, NV 89031-4411
Phone
(916) 579-9668
NPI assigned
Jan 19, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A-1720 NV Primary

Addresses

Primary practice location

3870 W Ann Rd
North Las Vegas, NV 89031-4411

Mailing address

9604 Marigny CT
Las Vegas, NV 89129-7850
Phone (916) 579-9668

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A-1720NVMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1871354464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9604 MARIGNY CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297850",
            "telephone_number": "916-579-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3870 W ANN RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890314411",
            "telephone_number": "916-579-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAQUILING",
        "first_name": "KEITH PAOLO",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-19",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NV",
            "license": "A-1720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.