NPIMap

Organization Active NPI

Noel R. Fajardo MD PC

  • Specialist
  • Las Vegas, NV
National Provider Identifier
1891056370
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
12053 Issued in NV
Legal business name
NOEL R. FAJARDO MD PC
Practice address
3901 S Maryland Pkwy
Las Vegas, NV 89119-7537
Phone
(702) 982-7240
Fax
(702) 952-5444
NPI assigned
May 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Dr. Noel Rodriguez Fajardo, MDNPI 1255305520
Title
President
Phone
(702) 982-7240

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 12053 NV Primary

Addresses

Primary practice location

3901 S Maryland Pkwy
Las Vegas, NV 89119-7537

Mailing address

7315 S. Pecos Rd
Suite 101
Las Vegas, NV 89120
Phone (702) 982-7240

Other practice location 1

7315 S Pecos Rd Ste 101
Las Vegas, NV 89120-3768
Phone (702) 982-7240

Other names 1

  • LAS VEGAS GASTROENTEROLOGY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120705000122 NV Part B Supplier - Clinic/Group Practice 3971768540 Receives reassigned benefits from 7 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

2430 W Horizon Ridge Pkwy
Ste 100
Henderson, NV 89052
Phone (702) 982-7240

7315 S Pecos Rd
Ste 101
Las Vegas, NV 89120
Phone (702) 982-7240

7315 S Pecos Rd
#101
Las Vegas, NV 89120

3910 S Maryland Pkwy
Ste 9B
Las Vegas, NV 89119
Phone (702) 982-7240

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1891056370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7315 S. PECOS RD",
            "address_2": "SUITE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89120",
            "telephone_number": "702-982-7240",
            "fax_number": "702-952-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197537",
            "telephone_number": "702-982-7240",
            "fax_number": "702-952-5444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7315 S Pecos Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891203768",
            "country_code": "US",
            "telephone_number": "702-982-7240",
            "fax_number": "702-952-5444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOEL R. FAJARDO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-31",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "FAJARDO",
        "authorized_official_first_name": "NOEL",
        "authorized_official_middle_name": "RODRIGUEZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-982-7240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NV",
            "license": "12053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAS VEGAS GASTROENTEROLOGY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LAS VEGAS GASTROENTEROLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.