Individual provider Active NPI

Kanop Metriyakool, MD

  • Anesthesiology Physician
  • Las Vegas, NV
National Provider Identifier
1912978305
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
10537 Issued in NV
Practice address
9127 W Russell Rd Ste 110
Las Vegas, NV 89148-1253
Phone
(702) 878-0070
Fax
(702) 209-2064
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 10537 NV Primary

Addresses

Primary practice location

9127 W Russell Rd Ste 110
Las Vegas, NV 89148-1253

Mailing address

9127 W Russell Rd Ste 110
Las Vegas, NV 89148-1253
Phone (702) 878-0070

Other identifiers 1

IdentifierTypeStateIssuer
100500095MedicaidNV

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
I20040106000395 NV Practitioner - Anesthesiology 4789583071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Wayne State University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fielden,Hanson,Isaacs,Miyada,Robison,Yeh LTDGroup PAC ID 5799683462, 168 clinicians

Practice addresses (Care Compare)

3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Phone (702) 616-5000

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 961-8434

5400 S Rainbow Blvd
Las Vegas, NV 89118-1859
Phone (702) 853-3000

657 N Town Ctr Dr
Las Vegas, NV 89144-6367
Phone (702) 233-7000

8280 W Warm Springs Rd
Las Vegas, NV 89113-3612
Phone (702) 492-8000

9127 W Russell Rd
Suite 110
Las Vegas, NV 89148-1253
Phone (702) 878-0700

Hospital & facility affiliations

  • Sunrise Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290003
  • Mountainview Hospital Hospital, Las Vegas, NV, CCN 290039
  • Summerlin Hospital Medical Center Hospital, Las Vegas, NV, CCN 290041
  • Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045

Merit-based Incentive Payment System (MIPS)

Final score
78.25 of 100Reported as group
Quality
74.41
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10537NVMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fielden Hanson Isaacs Miyada Robison Yeh LTD Anesthesiology CurrentSince Sep 1, 2003 Accepting new patients
Summit Anesthesia Consultants, Inc Anesthesiology Past Accepting new patients
Arizona Anesthesia Consultants, Inc. Anesthesiology PastSince Feb 2, 2020 Accepting new patients

Locations

9127 W Russell Rd
Ste 110
Las Vegas, NV 89148
Phone (702) 209-2042

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

Organizations & group practices 3

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 5

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1912978305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9127 W RUSSELL RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481253",
            "telephone_number": "702-878-0070",
            "fax_number": "702-209-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9127 W RUSSELL RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481253",
            "telephone_number": "702-878-0070",
            "fax_number": "702-209-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METRIYAKOOL",
        "first_name": "KANOP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "10537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100500095",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.