Active NPI
George Peter Mulopulos, M.D.
- Diagnostic Radiology Physician
- Las Vegas, NV
National Provider Identifier
1912934498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 5356
- Practice address
- 67 Princeville LN
Las Vegas, NV 89113-1369 - Phone
- (952) 595-1100
- Fax
- (612) 294-4903
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 5356 | NV | Primary |
| Diagnostic Neuroimaging (Radiology) Physician | 2085D0003X | 5356 | NV | |
| Neuroradiology Physician | 2085N0700X | 5356 | NV | |
| Body Imaging Physician | 2085B0100X | 5356 | NV |
Addresses
Primary practice location
67 Princeville LN
Las Vegas, NV 89113-1369
Mailing address
11995 Singletree LN
Suite 500
Eden Prairie, MN 55344-5347
Phone (952) 595-1301
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5356 | NV | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Hope Medical Group of Illinois PLLC | Past | Accepting new patients | |
| Pueblo Medical Imaging, LLC | Neuroradiology | Past | Accepting new patients |
| J Paul Wiesner & Associates Chartered | Neuroradiology | Past | Accepting new patients |
| Ellis Bandt Birkin Kollins & Wong PLLC | Diagnostic Radiology | Past | Accepting new patients |
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.
-
- Diagnostic Radiology Physician
- Las Vegas, NV
- NPI 1578584678
-
- Diagnostic Radiology Physician
- Las Vegas, NV
- NPI 1487606026
Neuroradiology
-
- Diagnostic Radiology Physician
- Las Vegas, NV
- NPI 1952353591
Neuroradiology
-
- Specialist
- Zion, IL
- NPI 1548258072
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435017600000",
"number": "1912934498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11995 SINGLETREE LN",
"address_2": "SUITE 500",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553445347",
"telephone_number": "952-595-1301",
"fax_number": "612-294-4903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 PRINCEVILLE LN",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891131369",
"telephone_number": "952-595-1100",
"fax_number": "612-294-4903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULOPULOS",
"first_name": "GEORGE",
"middle_name": "PETER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2015-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NV",
"license": "5356",
"primary": true
},
{
"code": "2085D0003X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Neuroimaging",
"state": "NV",
"license": "5356",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "NV",
"license": "5356",
"primary": false
},
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "NV",
"license": "5356",
"primary": false
}
],
"identifiers": [],
"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 Jun 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.