Individual provider Active NPI

George Peter Mulopulos, M.D.

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1912934498
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5356 Issued in NV
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

Updated by the provider on Jun 23, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5356NVMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Group of Illinois PLLC Past Accepting new patients
Pueblo Medical Imaging, LLC Neuroradiology PastSince Dec 16, 1998 Accepting new patients
J Paul Wiesner & Associates Chartered Neuroradiology PastSince Nov 3, 2019 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.

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

Verify at the official NPI Registry.