Active NPI
Romeo Rosales, PAC
- Physician Assistant
- Las Vegas, NV
National Provider Identifier
1952372898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA862
- Practice address
- 1276 S Nellis Blvd
Las Vegas, NV 89104-5782 - Phone
- (725) 269-6465
- NPI assigned
- Jan 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA862 | NV | Primary |
Addresses
Primary practice location
1276 S Nellis Blvd
Las Vegas, NV 89104-5782
Mailing address
102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250
Phone (888) 987-1151
Other practice location 1
2300 W Charleston Blvd
Pain Mgmt
Las Vegas, NV 89102-2149
Phone (702) 877-5370
Other practice location 2
4500 W Oakey Blvd
Las Vegas, NV 89102-1527
Phone (702) 873-5100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100504055 | Medicaid | NV | |
| PA862 | Other | NV | STATE LICENSE |
| 1952372898 | Medicaid | NV |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1501 W Sunset Rd
Henderson, NV 89014-6636
Phone (725) 269-7001
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10705 | MN | MD | Family Nurse Practitioner |
Interoperability endpoints
- romeo.rosales.1@18353.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Henderson, NV
- NPI 1487303145
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749168000000",
"number": "1952372898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 WOODMONT BLVD STE 600",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372055250",
"telephone_number": "888-987-1151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1276 S NELLIS BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891045782",
"telephone_number": "725-269-6465"
}
],
"practiceLocations": [
{
"address_1": "2300 W Charleston Blvd",
"address_2": "Pain Mgmt",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891022149",
"country_code": "US",
"telephone_number": "702-877-5370",
"fax_number": "702-366-9064",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4500 W Oakey Blvd",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891021527",
"country_code": "US",
"telephone_number": "702-873-5100",
"fax_number": "702-873-8093",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSALES",
"first_name": "ROMEO",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-30",
"last_updated": "2025-06-06",
"certification_date": "2025-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NV",
"license": "PA862",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100504055",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "PA862",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1952372898",
"state": "NV"
}
],
"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 Jun 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.