Individual provider Active NPI

Mary Laine Khine-Stickler, M.D.

  • Maternal & Fetal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1891762571
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
22253 Issued in NV
Practice address
5761 South Fort Apache Road
Las Vegas, NV 89148-5506
Phone
(702) 341-6610
Fax
(702) 341-6961
NPI assigned
Mar 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 25MA07354000 NJ
Maternal & Fetal Medicine Physician 207VM0101X 22253 NV Primary

Addresses

Primary practice location

5761 South Fort Apache Road
Las Vegas, NV 89148-5506

Mailing address

5761 South Fort Apache Road
Las Vegas, NV 89148-5506
Phone (702) 341-6610

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221017001815 NV Practitioner - Other (Physician) 2567511397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Undefined Physician Type (Specify)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adashek and Wilkes LLPGroup PAC ID 4385645209, 6 clinicians

Practice addresses (Care Compare)

5761 S Fort Apache Rd
BLDG 8
Las Vegas, NV 89148-5506
Phone (702) 341-6610

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07354000NJMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adashek and Wilkes LLP Maternal & Fetal Medicine CurrentSince Jul 25, 2022 Accepting new patients
Practice Associates,Inc Past Accepting new patients
Specialty Care of Practice Associates,PA Past Accepting new patients

Locations

3001 W Horizon Ridge Pkwy
Henderson, NV 89052
Phone (702) 341-6610

10105 Banburry Cross Dr
Ste 430
Las Vegas, NV 89144
Phone (702) 341-6610

600 S Rancho Dr
Ste 106
Las Vegas, NV 89106

5761 S Fort Apache Rd
Las Vegas, NV 89148
Phone (702) 341-6610

5761 S Fort Apache Rd
Bldg 8
Las Vegas, NV 89148
Phone (702) 341-6610

Organizations & group practices 3

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1891762571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5761 SOUTH FORT APACHE ROAD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485506",
            "telephone_number": "702-341-6610",
            "fax_number": "702-341-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5761 SOUTH FORT APACHE ROAD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485506",
            "telephone_number": "702-341-6610",
            "fax_number": "702-341-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHINE-STICKLER",
        "first_name": "MARY",
        "middle_name": "LAINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NJ",
            "license": "25MA07354000",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NV",
            "license": "22253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.