Individual provider Active NPI

Roxana Tejada-Jitsuya, M.D.

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1932361904
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
13608 Issued in NV
Practice address
2017 Pinto LN
Las Vegas, NV 89106-4018
Phone
(702) 542-5868
Fax
(702) 991-9807
NPI assigned
Jun 30, 2008
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13608 NV Primary
Hospitalist Physician 208M00000X 13608 NV

Addresses

Primary practice location

2017 Pinto LN
Las Vegas, NV 89106-4018

Mailing address

2017 Pinto LN
Las Vegas, NV 89106-4018
Phone (702) 542-5868

Other identifiers 1

IdentifierTypeStateIssuer
1932361904MedicaidNV

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
I20101122000309 NV Practitioner - Internal Medicine 9335335991 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emediate Infusion Center LLC CurrentSince Jan 1, 2022 Accepting new patients
Hanna Health Clinic Internal Medicine Current Accepting new patients

Locations

2017 Pinto Ln
Las Vegas, NV 89106
Phone (702) 333-2620

501 S Rancho Dr
Ste I62
Las Vegas, NV 89106
Phone (702) 384-7433

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1932361904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 PINTO LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064018",
            "telephone_number": "702-542-5868",
            "fax_number": "702-991-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 PINTO LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064018",
            "telephone_number": "702-542-5868",
            "fax_number": "702-991-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJADA-JITSUYA",
        "first_name": "ROXANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "13608",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "13608",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932361904",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.