NPIMap

Individual provider Active NPI

Marwah Al-Khazaali, M.D.

  • Nephrology Physician
  • Las Vegas, NV
National Provider Identifier
1962896043
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
19665 Issued in NV
Practice address
1294 S Jones Blvd
Las Vegas, NV 89146
Phone
(702) 877-1887
Fax
(702) 877-4536
NPI assigned
Mar 26, 2015
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 19665 NV
Nephrology Physician 207RN0300X 19665 NV Primary

Addresses

Primary practice location

1294 S Jones Blvd
Las Vegas, NV 89146

Mailing address

1294 S Jones Blvd
Las Vegas, NV 89146
Phone (702) 877-1887

Other practice location 1

2040 W Charleston Blvd Ste 300
Las Vegas, NV 89102-2244
Phone (702) 671-2341

Other identifiers 1

IdentifierTypeStateIssuer
1962896043MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200612002085 NV Practitioner - NephrologyPractitioner - Internal Medicine 9032531405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

8775 Deer Springs Way
Las Vegas, NV 89149-0416
Phone (702) 877-1887

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19665NVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology & Endocrine Associates Inc CurrentSince Jul 1, 2020 Accepting new patients
Nephrology & Endocrine Associates Inc Nephrology CurrentSince Jul 1, 2020 Accepting new patients

Locations

100 N Green Valley Pkwy
Ste 310
Henderson, NV 89074
Phone (702) 565-6565

1294 S Jones Blvd
Las Vegas, NV 89146
Phone (702) 877-1877

500 S Rancho Dr
Ste 12
Las Vegas, NV 89106
Phone (702) 877-1877

8775 Deer Springs Way
Las Vegas, NV 89149
Phone (702) 395-2488

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: marwah.al-khazaali@direct.davitaphysiciansolutions.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1962896043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89146",
            "telephone_number": "702-877-1887",
            "fax_number": "702-877-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89146",
            "telephone_number": "702-877-1887",
            "fax_number": "702-877-4536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2040 W Charleston Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891022244",
            "country_code": "US",
            "telephone_number": "702-671-2341",
            "fax_number": "702-671-2376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-KHAZAALI",
        "first_name": "MARWAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-26",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "19665",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NV",
            "license": "19665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962896043",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.