Individual provider Active NPI

John Mason McKittrick

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Las Vegas, NV
National Provider Identifier
1891879706
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
DO2382 Issued in NV
Practice address
1180 N Town Center Dr Ste 100
Las Vegas, NV 89144-6308
Phone
(702) 202-2060
Fax
(702) 605-2892
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X DO2382 NV Primary

Addresses

Primary practice location

1180 N Town Center Dr Ste 100
Las Vegas, NV 89144-6308

Mailing address

1180 N Town Center Dr Ste 100
Las Vegas, NV 89144-6308
Phone (702) 202-2060

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181121002365 NV Practitioner - Hospice/Palliative CarePractitioner - Family Practice 5294042107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Physicians Kumar PLLCGroup PAC ID 3577893965, 37 clinicians

Practice addresses (Care Compare)

6090 S Fort Apache Rd
Suite 140
Las Vegas, NV 89148-5618
Phone (702) 202-0534

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Physicians (Kumar) PLLC Family Medicine CurrentSince Aug 30, 2024 Accepting new patients
Reliant Physicians (Kumar) PLLC PastSince Sep 24, 2023 Accepting new patients
Infinity Hospice Care LLC Family Medicine Past Accepting new patients

Locations

1140 N Town Center Dr
Ste 100
Las Vegas, NV 89144
Phone (702) 202-2060

6090 S Fort Apache Rd
Ste 140
Las Vegas, NV 89148
Phone (702) 202-0534

1180 N Town Center Dr
Ste 100
Las Vegas, NV 89144
Phone (702) 202-2060

Organizations & group practices 4

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 4

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1891879706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 N TOWN CENTER DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446308",
            "telephone_number": "702-202-2060",
            "fax_number": "702-605-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 N TOWN CENTER DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446308",
            "telephone_number": "702-202-2060",
            "fax_number": "702-605-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKITTRICK",
        "first_name": "JOHN",
        "middle_name": "MASON",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NV",
            "license": "DO2382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.