NPIMap

Individual provider Active NPI

John M Menezes, M.D.

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Las Vegas, NV
National Provider Identifier
1891773404
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X
License
10200 Issued in NV
Practice address
1707 W Charleston Blvd
#190, Plastic Surgery Clinic
Las Vegas, NV 89102-2351
Phone
(702) 671-5110
Fax
(702) 684-6592
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X 10200 NV Primary

Addresses

Primary practice location

1707 W Charleston Blvd
#190, Plastic Surgery Clinic
Las Vegas, NV 89102-2351

Mailing address

3016 W Charleston Blvd
Ste 100, Credentialing Department
Las Vegas, NV 89102-1973
Phone (702) 780-2311

Other identifiers 2

IdentifierTypeStateIssuer
CS11260OtherNVPHARMACY/CDS
002018698MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100429000617 NV Practitioner - Plastic and Reconstructive Surgery 3274660873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Minnesota Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Practice addresses (Care Compare)

1707 W Charleston Blvd
Suite 190
Las Vegas, NV 89102-2352
Phone (702) 671-6412

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10200NVMDPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine Current Accepting new patients
Unlv Medicine CurrentSince Jul 1, 2017 Accepting new patients
Unlv Medicine CurrentSince Jul 1, 2017 Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients

Locations

1707 W Charleston Blvd
Ste 190
Las Vegas, NV 89102
Phone (702) 671-5110

2040 W Charleston Blvd
Ste 301
Las Vegas, NV 89102

4000 E Charleston Blvd
Ste 130
Las Vegas, NV 89104
Phone (702) 480-1031

3016 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 780-2315

5380 S Rainbow Blvd
Ste 324
Las Vegas, NV 89118
Phone (702) 992-6828

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

1707 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 671-5070

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

2724 N Tenaya Way
Fl 2
Las Vegas, NV 89128
Phone (702) 939-8557

1707 W Charleston Blvd
Ste 220
Las Vegas, NV 89102
Phone (702) 671-5070

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

2724 N Tenaya Way
#2
Las Vegas, NV 89128

Interoperability endpoints

  • Direct secure messaging: jmenezes12930@direct.umcsn.com

Organizations & group practices 5

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1891773404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD",
            "address_2": "STE 100, CREDENTIALING DEPARTMENT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021973",
            "telephone_number": "702-780-2311",
            "fax_number": "702-671-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W CHARLESTON BLVD",
            "address_2": "#190, PLASTIC SURGERY CLINIC",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022351",
            "telephone_number": "702-671-5110",
            "fax_number": "702-684-6592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENEZES",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2023-03-07",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "NV",
            "license": "10200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY/CDS",
            "identifier": "CS11260",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018698",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.