Maria Rachel Chohlidakis, M.D.
Individual provider Active NPI Pediatrics Physician · Las Vegas, NV
NPI 1881970515 · NPPES record last updated Oct 22, 2015
Key facts
- NPI
- 1881970515
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 1559 (NV)
- Practice address
- 10105 Banburry Cross Drive
Suite 370
Las Vegas, NV 89144-6649 - Phone
- (702) 260-4525
- Fax
- (702) 869-0133
- NPI assigned
- Oct 26, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A121396 | CA | MD | Pediatrics Physician |
| 1559 | NV | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summerlin Hospital Medical Center L L C | Past | Accepting new patients | |
| Centennial Hills Hospital Medical Center | Past | Accepting new patients | |
| Spring Valley Medical Center | Past | Accepting new patients | |
| Southern Hills Medical Center, LLC | Past | Accepting new patients | |
| Desert Valley Pediatrics, LLP | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A121396 | CA | |
| Pediatrics Physician | 208000000X | 1559 | NV | Yes |
Addresses
Primary practice location
10105 Banburry Cross Drive
Suite 370
Las Vegas, NV 89144-6649
Mailing address
10105 Banburry Cross Drive
Suite 370
Las Vegas, NV 89144-6649
Phone (702) 260-4525
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RHM53955F | Medicaid | CA | |
| GR0089250 | Medicaid | CA |
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All providers in Las Vegas, NV · Pediatrics Physician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.