Juan Carlos Martinez-Moreno MD PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

JUAN CARLOS MARTINEZ-MORENO MD PC

Doing business as

Nevada Muscle and Nerve

Practice address

3017 W Charleston Blvd
Suite 90
Las Vegas, NV 89102-1941

Phone

(702) 826-2816

Fax

(702) 826-2813

NPI assigned

Nov 12, 2014

Last updated

Jun 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Juan Carlos Martinez-Moreno, M.D.NPI 1114118676

Title

President

Phone

(702) 826-2816

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Nevada Muscle and Nerve Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

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.

• Juan Carlos Martinez-Moreno, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Las Vegas, NV
  • NPI 1114118676
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1962808303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 W CHARLESTON BLVD",
            "address_2": "SUITE 90",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021941",
            "telephone_number": "702-826-2816",
            "fax_number": "702-826-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 W CHARLESTON BLVD",
            "address_2": "SUITE 90",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021941",
            "telephone_number": "702-826-2816",
            "fax_number": "702-826-2813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUAN CARLOS MARTINEZ-MORENO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-12",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ-MORENO",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "CARLOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-826-2816",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NV",
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NV",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114118676",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nevada Muscle and Nerve",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Medicine & Rehabilitation Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Medicine & Rehabilitation Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.