Ezeanolue, MD, Precision Surgery Center of Las Vegas, PLLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

NV20141278772 Issued in NV

Legal business name

EZEANOLUE, MD, PRECISION SURGERY CENTER OF LAS VEGAS, PLLC

Doing business as

Precision Surgery Center

Practice address

1701 Bearden Dr
Suite 202
Las Vegas, NV 89106-4189

Phone

(702) 310-9110

Fax

(702) 310-9114

NPI assigned

Jan 27, 2015

Organization subpart

No

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

Authorized official

Name

Dolue David Ezeanolue, M.D.NPI 1700883014

Title

Medical Director

Phone

(702) 310-9110

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Precision Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Ambulatory surgical center certification: CCN 29C0001118

Legal name

PRECISION SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 16, 2017

Last certification

Nov 17, 2020

Ownership / control type

Proprietary

Facility address

1701 Bearden Drive, Ste 202
Las Vegas, NV 89106

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Dolue David Ezeanolue, MD

  • Interventional Pain Medicine Physician
  • Las Vegas, NV
  • NPI 1700883014
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503878400000",
    "number": "1891185096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 BEARDEN DR",
            "address_2": "SUITE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064189",
            "telephone_number": "702-310-9110",
            "fax_number": "702-310-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 BEARDEN DR",
            "address_2": "SUITE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064189",
            "telephone_number": "702-310-9110",
            "fax_number": "702-310-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZEANOLUE, MD, PRECISION SURGERY CENTER OF LAS VEGAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-27",
        "last_updated": "2017-08-28",
        "status": "A",
        "authorized_official_last_name": "EZEANOLUE",
        "authorized_official_first_name": "DOLUE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "702-310-9110",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NV",
            "license": "NV20141278772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Precision Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chinenye Ezeanolue, MD
• Dolue David Ezeanolue, MD
• Echezona Edozie Ezeanolue, M.D.
• Edozie Ezeanolue, MD
• Kanayo Afamefina Ezeanolue, MD
• Chinazor Thelma Ezeli
• Gillian Ezell
• Layla Nicole Ezell, RBT
• Maya L Ezell
• Chinomso D Ezenwata, NP-C

• Ambulatory Surgical Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Ambulatory Surgical Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.