Individual provider Active NPI

Sumegha Mohanadasan, MD

  • Student in an Organized Health Care Education/Training Program
  • Las Vegas, NV
National Provider Identifier
1881444826
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1701 W Charleston Blvd Ste 230
Las Vegas, NV 89102-2312
Phone
(702) 676-3650
Fax
(702) 676-3635
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1701 W Charleston Blvd Ste 230
Las Vegas, NV 89102-2312

Mailing address

8600 W Gilmore Ave
Las Vegas, NV 89129-7684
Phone (702) 682-5232

Other practice location 1

6900 N Pecos Rd
North Las Vegas, NV 89086-4400
Phone (702) 791-9000

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
I20240812001868 NV Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6406394204

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine PastSince Jul 28, 2024 Accepting new patients

Organizations & group practices 1

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": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1881444826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 W GILMORE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297684",
            "telephone_number": "702-682-5232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD STE 230",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022312",
            "telephone_number": "702-676-3650",
            "fax_number": "702-676-3635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6900 N Pecos Rd",
            "address_purpose": "LOCATION",
            "city": "North Las Vegas",
            "state": "NV",
            "postal_code": "890864400",
            "country_code": "US",
            "telephone_number": "702-791-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHANADASAN",
        "first_name": "SUMEGHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-07-24",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.