NPIMap

Individual provider Active NPI

Mark Vandenbosch, M.D.

  • Anesthesiology Physician
  • Las Vegas, NV
National Provider Identifier
1871686733
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
14668 Issued in NV
Practice address
1330 S Valley View Blvd
Las Vegas, NV 89102-1865
Phone
(702) 675-4600
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME64003 FL
Anesthesiology Physician 207L00000X 14668 NV Primary

Addresses

Primary practice location

1330 S Valley View Blvd
Las Vegas, NV 89102-1865

Mailing address

2844 Evening Rock St
Las Vegas, NV 89135-1631
Phone (321) 698-6853

Other identifiers 1

IdentifierTypeStateIssuer
374010200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130717000057 NV Practitioner - Anesthesiology 0143210807 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Miami, LM Miller School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Red Rock Anesthesia Consultants LLCGroup PAC ID 4284910290, 109 clinicians

Practice addresses (Care Compare)

5400 S Rainbow Blvd
Las Vegas, NV 89118-1859
Phone (702) 325-4651

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group Rhodes P C Anesthesiology Current Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Dec 1, 2019 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Dec 1, 2014 Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients
Anesthesia Management Services LLC Anesthesiology CurrentSince May 26, 2021 Accepting new patients
Anesthesia Management Services Anesthesiology CurrentSince Sep 23, 2021 Accepting new patients
Red Rock Anesthesia Consultants LLC Anesthesiology CurrentSince Jul 1, 2024 Accepting new patients
Palm Bay Anesthesia, Inc PastSince Sep 9, 2003 Accepting new patients
Palm Bay Anesthesia Associates PA Anesthesiology PastSince Aug 1, 1998 Accepting new patients
Brevard Physician Associates, PLLC Anesthesiology Past Accepting new patients

Locations

58 N Pecos Rd
Henderson, NV 89074
Phone (702) 822-2000

2555 Box Canyon Dr
Las Vegas, NV 89128
Phone (702) 316-4400

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

1330 S Valley View Blvd
Las Vegas, NV 89102
Phone (702) 562-8564

5400 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 252-7342

2450 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8660

10105 Banburry Cross Dr
Ste 460
Las Vegas, NV 89144
Phone (702) 691-9160

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

Organizations & group practices 10

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1871686733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2844 EVENING ROCK ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351631",
            "telephone_number": "321-698-6853",
            "fax_number": "702-818-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 S VALLEY VIEW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021865",
            "telephone_number": "702-675-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBOSCH",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME64003",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "14668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374010200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.