NPIMap

Individual provider Active NPI

Michael Carducci, MD

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1902830045
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
10479 Issued in NV
Practice address
2020 Palomino LN
Ste 100
Las Vegas, NV 89106-4894
Phone
(702) 759-8600
Fax
(702) 384-1815
NPI assigned
Jul 11, 2006
Last updated
Feb 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 10479 NV Primary

Addresses

Primary practice location

2020 Palomino LN
Ste 100
Las Vegas, NV 89106-4894

Mailing address

2020 Palomino LN
Las Vegas, NV 89106-4894
Phone (702) 759-8600

Other identifiers 2

IdentifierTypeStateIssuer
200468420AMedicaidOK
201890008MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040210000938 NV Practitioner - Diagnostic Radiology 9638063753 Reassigns benefits to 5 organizations
I20260320003086 OH Practitioner - Diagnostic Radiology 9638063753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Radiology and Interventional Associates IncGroup PAC ID 8729976964, 251 clinicians
Lucidsolutions IncGroup PAC ID 0749603462, 84 clinicians

Practice addresses (Care Compare)

11765 San Rosarita CT
Las Vegas, NV 89138-6022
Phone (614) 340-7740

1805 27TH St
Portsmouth, OH 45662-2640
Phone (740) 356-8681

3021 Hammerwood Dr
Las Vegas, NV 89135-2218
Phone (614) 340-7740

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10479NVMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Radiology and Interventional Associates Inc Diagnostic Radiology CurrentSince Oct 25, 2023 Accepting new patients
Lucidsolutions, Inc. Diagnostic Radiology CurrentSince Dec 15, 2023 Accepting new patients
Ellis Bandt Birkin Kollins & Wong PLLC Diagnostic Radiology CurrentSince Aug 15, 2003 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Aug 13, 2019 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Aug 13, 2019 Accepting new patients
Shelin Agrawal and Hyer PLLC Diagnostic Radiology CurrentSince Jan 21, 2012 Accepting new patients
Spring Valley Medical Center Past Accepting new patients

Locations

2811 W Horizon Ridge Pkwy
Henderson, NV 89052

2020 Palomino Ln
Las Vegas, NV 89106
Phone (702) 384-5210

2020 Palomino Ln
Ste 100
Las Vegas, NV 89106
Phone (702) 759-8779

2075 E Flamingo Rd
Las Vegas, NV 89119
Phone (702) 369-7613

3920 S Eastern Ave
Ste 100
Las Vegas, NV 89119
Phone (702) 759-8779

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

Interoperability endpoints

  • Direct secure messaging: mcarducci11534@direct.umcsn.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1902830045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN",
            "address_2": "STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDUCCI",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "10479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200468420A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201890008",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.