Individual provider Active NPI

Doreen Tagavilla Cariaga

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1962045211
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4107 Issued in NV
Practice address
2012 S Jones Blvd
Las Vegas, NV 89146-3151
Phone
(702) 360-1137
NPI assigned
Oct 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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 4107 NV Primary

Addresses

Primary practice location

2012 S Jones Blvd
Las Vegas, NV 89146-3151

Mailing address

9712 Red Horse St
Las Vegas, NV 89143-1158
Phone (702) 544-3406

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210212001231 NV Practitioner - Physical Therapist in Private Practice 3870908411 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Speakeasy Therapy Services, LLC Physical Therapist CurrentSince Aug 18, 2024 Accepting new patients
Therapy West LLC Physical Therapist PastSince Jan 29, 2021 Accepting new patients
My Left Foot Children'S Therapy Past Accepting new patients
My Left Foot Children'S Therapy, LLC. Past Accepting new patients

Locations

2490 Paseo Verde Pkwy
Ste 155
Henderson, NV 89074
Phone (702) 703-5540

6345 S Jones Blvd
Ste 300
Las Vegas, NV 89118
Phone (702) 515-7009

Organizations & group practices 5

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": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1962045211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9712 RED HORSE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891431158",
            "telephone_number": "702-544-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463151",
            "telephone_number": "702-360-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARIAGA",
        "first_name": "DOREEN",
        "middle_name": "TAGAVILLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-18",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4107",
            "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 Oct 18, 2019; 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.