Individual provider Active NPI

Scott Robert Pensivy, P.T.

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1952361107
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0449 Issued in NV
Practice address
9070 W Cheyenne Ave
Ste 100
Las Vegas, NV 89129-8934
Phone
(702) 655-8535
Fax
(702) 656-5863
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0449 NV Primary

Addresses

Primary practice location

9070 W Cheyenne Ave
Ste 100
Las Vegas, NV 89129-8934

Mailing address

9070 W Cheyenne Ave
Ste 100
Las Vegas, NV 89129-8934
Phone (702) 655-8535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051108001082 NV Practitioner - Physical Therapist in Private Practice 1759307747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0449NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Executive Fitness Inc Physical Therapist PastSince Jul 1, 2002 Accepting new patients
Executive Fitness Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1952361107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9070 W CHEYENNE AVE",
            "address_2": "STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891298934",
            "telephone_number": "702-655-8535",
            "fax_number": "702-656-5863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9070 W CHEYENNE AVE",
            "address_2": "STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891298934",
            "telephone_number": "702-655-8535",
            "fax_number": "702-656-5863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENSIVY",
        "first_name": "SCOTT",
        "middle_name": "ROBERT",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "0449",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.