NPIMap

Organization Active NPI

Portney Medical Group LTD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1962604884
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9534 Issued in NV
Legal business name
PORTNEY MEDICAL GROUP LTD
Practice address
9417 Queen Charlotte Dr
Las Vegas, NV 89145-8707
Phone
(702) 240-0874
Fax
(702) 240-3627
NPI assigned
Jun 4, 2007
Last updated
Dec 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Authorized official

Name
Dr. Alexander Leon Portney, MDNPI 1437225927
Title
Medical Director
Phone
(702) 240-0874

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9534 NV Primary

Addresses

Primary practice location

9417 Queen Charlotte Dr
Las Vegas, NV 89145-8707

Mailing address

810 S Durango Dr
Suite 100
Las Vegas, NV 89145-2423
Phone (702) 240-0874

Other identifiers 1

IdentifierTypeStateIssuer
100506921MedicaidNV

National Provider Directory

National Provider Directory

Locations

810 S Durango Dr
Ste 100
Las Vegas, NV 89145
Phone (702) 386-6052

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1962604884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 S DURANGO DR",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891452423",
            "telephone_number": "702-240-0874",
            "fax_number": "702-240-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9417 QUEEN CHARLOTTE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891458707",
            "telephone_number": "702-240-0874",
            "fax_number": "702-240-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTNEY MEDICAL GROUP LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "PORTNEY",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "702-240-0874",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "9534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506921",
            "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 Dec 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.