NPIMap

Individual provider Active NPI

Alexander B Gidaya, MD

  • Vascular Surgery Physician
  • Las Vegas, NV
National Provider Identifier
1962931584
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
25860 Issued in NV
Practice address
8930 W Sunset Rd # 250
Las Vegas, NV 89148-5008
Phone
(702) 565-8346
Fax
(702) 202-2000
NPI assigned
Jun 7, 2017
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25860 NV
Vascular Surgery Physician 2086S0129X 25860 NV Primary

Addresses

Primary practice location

8930 W Sunset Rd # 250
Las Vegas, NV 89148-5008

Mailing address

8930 W Sunset Rd # 250
Las Vegas, NV 89148-5008
Phone (702) 565-8346

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
I20241101001846 NV Practitioner - Vascular Surgery 9032465729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Eastern Virginia Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vegas Vascular Specialists PLLCGroup PAC ID 8325417793, 9 clinicians

Practice addresses (Care Compare)

8930 W Sunset Rd
Suite 250
Las Vegas, NV 89148-5008
Phone (702) 565-8346

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal35
Leg revascularization (restoring blood flow)32
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25860NVMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vegas Vascular Specialists PLLC Vascular Surgery CurrentSince Oct 15, 2024 Accepting new patients
Las Vegas Surgical Associates LLP Surgery CurrentSince Oct 15, 2024 Accepting new patients

Locations

8930 W Sunset Rd
Ste 250
Las Vegas, NV 89148
Phone (702) 258-7788

9811 W Charleston Blvd
Unit 2640
Las Vegas, NV 89117

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 10

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1962931584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 W SUNSET RD # 250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485008",
            "telephone_number": "702-565-8346",
            "fax_number": "702-202-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8930 W SUNSET RD # 250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485008",
            "telephone_number": "702-565-8346",
            "fax_number": "702-202-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIDAYA",
        "first_name": "ALEXANDER",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "25860",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NV",
            "license": "25860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.