Activate Wound Care LLC
Organization Active NPI General Practice Physician · Las Vegas, NV
NPI 1932095809 · NPPES record last updated Jun 16, 2025
Key facts
- NPI
- 1932095809
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- ACTIVATE WOUND CARE LLC
- Practice address
- 2626 S Rainbow Blvd Ste 102B
Las Vegas, NV 89146-4005 - Phone
- (702) 845-7292
- NPI assigned
- Jun 16, 2025
- Organization subpart
- No
Authorized official
- Name
- Miguel Adrian Ayuste Yu, MD
- Title
- Manager
- Phone
- (702) 845-7292
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250729002785 | NV | Part B Supplier - Clinic/Group Practice | 4385151844 |
Receives reassigned benefits from 1 practitioner Practice locations: Las Vegas, NV |
National Provider Directory
Locations
2626 S Rainbow Blvd
Ste 102B
Las Vegas, NV 89146
Phone (702) 845-7292
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
2626 S Rainbow Blvd Ste 102B
Las Vegas, NV 89146-4005
Mailing address
2626 S Rainbow Blvd Ste 102B
Las Vegas, NV 89146-4005
Phone (702) 845-7292
Other providers in Las Vegas, NV
- Act Counseling Center & Henderson, Prof. LLC
- Act Medical Group-Las Vegas Inc
- Action Therapeutics LLC
- Activate Healthcare - CHC Nellis
- Activate Home Health Care LLC
- Active Behavioral Health, LLC
- Active Body Chiropractic
- Active Health Chiropractic LLC
- Active Home Healthcare LLC
- Active Management LLC
All providers in Las Vegas, NV · General Practice Physician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.