Roger T. Braun, PA-C
Individual provider Active NPI Surgical Physician Assistant · Las Vegas, NV
NPI 1891380481 · NPPES record last updated Apr 4, 2022
Key facts
- NPI
- 1891380481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- PA2422 (NV)
- Practice address
- 2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609 - Phone
- (702) 294-7402
- Fax
- (702) 734-4900
- NPI assigned
- Mar 4, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Desert Orthopaedic Center LTD
Practice addresses (Care Compare)
2800 E Desert Inn Rd
Suite 100
Las Vegas, NV 89121-3609
Phone (702) 731-1616
Hospital & facility affiliations
- Spring Valley Hospital Medical Center
- Henderson Hospital
- Valley Hospital Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210427001592 | NV | Practitioner - Physician Assistant | 0749698041 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2422 | NV | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Desert Orthopaedic Billing LLC | Past | Accepting new patients |
Interoperability endpoints
- brart@doclv.emadirect.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2422 | NV | |
| Surgical Physician Assistant | 363AS0400X | PA2422 | NV | Yes |
Addresses
Primary practice location
2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609
Mailing address
2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609
Phone (702) 731-1616
Other practice location 1
8402 Centennial Pkwy
Las Vegas, NV 89149-4792
Phone (702) 731-1616
Other practice location 2
8689 W Charleston Blvd Ste 105
Las Vegas, NV 89117-5485
Phone (702) 731-1616
Other practice location 3
8205 W Warm Springs Rd Ste 250
Las Vegas, NV 89113-3646
Phone (702) 731-1616
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891380481 | Medicaid | NV | |
| PA2422 | Other | NV | MEDICAL LICENSE |
Other providers in Las Vegas, NV
- James Bratton
- Cynthia Braud
- Gary A Braun
- Kathryn Michelle Braun
- Natalie Mae Braun
- Sandra Braun
- Yeonjae J Braun
- Robert Brauner
- Irina Braunger
- Braunstein Medical Group LLC
All providers in Las Vegas, NV · Surgical Physician Assistant in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.