NPIMap

Organization Active NPI

Rd Prabhu-Lata K Shete MDS LTD

  • Multi-Specialty Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1912995309
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
RD PRABHU-LATA K SHETE MDS LTD
Practice address
5701 W Charleston Blvd
Suite 100
Las Vegas, NV 89146-1217
Phone
(702) 877-9514
Fax
(702) 877-0399
NPI assigned
Oct 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rachakonda Dayananda Prabhu, MDNPI 1538156633
Title
President
Phone
(702) 877-9514

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

5701 W Charleston Blvd
Suite 100
Las Vegas, NV 89146-1217

Mailing address

5701 W Charleston Blvd
Suite 100
Las Vegas, NV 89146-1217
Phone (702) 877-9514

Other identifiers 2

IdentifierTypeStateIssuer
100506357MedicaidNV
XGG00737OtherCAMEDI-CAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031210001032 NV Part B Supplier - Clinic/Group Practice 8820994791 Receives reassigned benefits from 27 practitioners
5 other NPIs on this enrollment
Practice locations: Henderson, NV; Pahrump, NV; North Las Vegas, NV; Las Vegas, NV
O20250923004378 NV DME Supplier - Sleep Laboratory/Medicine 8820994791 Practice locations: Las Vegas, NV

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
The Sleep Center - Charleston5701 W Charleston Blvd, Las Vegas, NV 89146-1256(702) 818-2444 Orthoses: Custom Fabricated Accepts assignmentParticipating since Jan 1, 2001

National Provider Directory

National Provider Directory

Locations

2920 N Green Valley Pkwy
Bldg 3
Henderson, NV 89014
Phone (702) 818-2444

8670 W Cheyenne Ave
Ste 220
Las Vegas, NV 89129
Phone (702) 818-2444

8670 W Cheyenne Ave
Ste 110
Las Vegas, NV 89129
Phone (725) 202-1497

5701 W Charleston Blvd
Ste 107
Las Vegas, NV 89146

1906 Civic Ctr Dr
North Las Vegas, NV 89030

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 31

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912995309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 W CHARLESTON BLVD",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461217",
            "telephone_number": "702-877-9514",
            "fax_number": "702-312-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 W CHARLESTON BLVD",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461217",
            "telephone_number": "702-877-9514",
            "fax_number": "702-877-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RD PRABHU-LATA K SHETE MDS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRABHU",
        "authorized_official_first_name": "RACHAKONDA",
        "authorized_official_middle_name": "DAYANANDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-877-9514",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506357",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "XGG00737",
            "state": "CA"
        }
    ],
    "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.