Individual provider Active NPI

Robert Donatelli, PT, PHD

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1891893939
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1873 Issued in NV
Practice address
7229 West Sahara Ave Suite 105
Suite 105
Las Vegas, NV 89117-4208
Phone
(702) 586-2177
Fax
(702) 586-2358
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1873 NV Primary

Addresses

Primary practice location

7229 West Sahara Ave Suite 105
Suite 105
Las Vegas, NV 89117-4208

Mailing address

7229 W Sahara Ave Ste 105
Las Vegas, NV 89117-2860
Phone (702) 586-2177

Other identifiers 1

IdentifierTypeStateIssuer
100507392MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051215000716 NV Practitioner - Physical Therapist in Private Practice 7517988629 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1873NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1891893939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7229 W SAHARA AVE STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172860",
            "telephone_number": "702-586-2177",
            "fax_number": "702-586-2358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7229 WEST SAHARA AVE SUITE 105",
            "address_2": "SUITE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891174208",
            "telephone_number": "702-586-2177",
            "fax_number": "702-586-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONATELLI",
        "first_name": "ROBERT",
        "credential": "PT, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100507392",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.