Penny Ann Pukall

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2491 Issued in NV

Practice address

1800 W Charleston Blvd
Las Vegas, NV 89102-2386

Phone

(702) 383-1958

NPI assigned

Sep 9, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Penny Ann Eldred Former name

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ppukall64470@direct.umcsn.com

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.

• University Medical Center of Southern Nevada

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1548393127
  Medicare reassignment NPD
• Sound Physicians Emergency Medicine of Nevada Bessler PLLC

  • Emergency Medicine Physician
  • Sparks, NV
  • NPI 1881151231
  Medicare reassignment
• Vituity-Nevada Medical Services Koury & Partners PC

  • Emergency Medicine Physician
  • Incline Village, NV
  • NPI 1396585154
  Medicare reassignment
• University Medical Center of Southern Nevada

  • Urgent Care Clinic/Center
  • Las Vegas, NV
  • NPI 1649832759
  NPD
• Vituity-Nevada Medical Services Koury & Partners PC

  • Emergency Medicine Physician
  • Henderson, NV
  • NPI 1528808383
  NPD
• Vituity-Nevada Medical Services Koury & Partners PC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1669272183
  NPD
• Association of University Physicians

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1093736621
  NPD (past)

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1952950370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022329",
            "telephone_number": "702-383-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022386",
            "telephone_number": "702-383-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUKALL",
        "first_name": "PENNY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2491",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61120377",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNY",
            "last_name": "ELDRED",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angelic Puglisi, PHARMD
• Thomas J Puhek, DDS
• Julieta Puia
• Katie Pujanauski, MGSW
• Maria Pujol
• Serenity Annette Pulawski
• Thomas S Pulice, MPA-C
• Erika Pulido Hernandez
• Ornel Pulido Pena
• Maria Pulido Ramirez

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.