NPIMap

Individual provider Active NPI

Conan R Parke, DPM

  • Foot & Ankle Surgery Podiatrist
  • Las Vegas, NV
National Provider Identifier
1871889824
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2004 Issued in NV
Practice address
2641 Box Canyon Dr Ste a
Las Vegas, NV 89128-0423
Phone
(702) 243-3668
Fax
(702) 243-3324
NPI assigned
Jun 28, 2011
Last updated
Jun 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 2004 NV Primary

Addresses

Primary practice location

2641 Box Canyon Dr Ste a
Las Vegas, NV 89128-0423

Mailing address

2641 Box Canyon Dr Ste a
Las Vegas, NV 89128-0423
Phone (702) 243-3668

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
I20150625001982 NV Practitioner - Podiatry 8729399175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
C Parke Podiatry LTDGroup PAC ID 3870921083, 2 clinicians

Practice addresses (Care Compare)

2641 Box Canyon Dr
Las Vegas, NV 89128-0419
Phone (702) 243-3668

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue737
Removal of skin lesions127
Removal of nail tissue400
Removal or shaving of skin growth33
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2004NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
C Parke Podiatry LTD Podiatrist CurrentSince Jan 29, 2015 Accepting new patients
Desert Springs Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Talbert Medical Group Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

2641 Box Canyon Dr
Ste A
Las Vegas, NV 89128
Phone (702) 243-3668

Interoperability endpoints

  • Direct secure messaging: advancedcarefootandanklecenter.conanparke@142146.advancedmd-direct.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1871889824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2641 BOX CANYON DR STE A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280423",
            "telephone_number": "702-243-3668",
            "fax_number": "702-243-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2641 BOX CANYON DR STE A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280423",
            "telephone_number": "702-243-3668",
            "fax_number": "702-243-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKE",
        "first_name": "CONAN",
        "middle_name": "R",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-28",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NV",
            "license": "2004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.