Tripleaim Healthcare
Organization Active NPI Critical Care Medicine (Internal Medicine) Physician · Las Vegas, NV
NPI 1972254332 · NPPES record last updated Mar 3, 2022
Key facts
- NPI
- 1972254332
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician 207RC0200X
- Legal business name
- TRIPLEAIM HEALTHCARE
- Practice address
- 2445 Ember Mist CT
Las Vegas, NV 89135-1075 - Phone
- (805) 208-0434
- NPI assigned
- Jan 17, 2022
- Organization subpart
- No
Authorized official
- Name
- Cheryl Lee
- Title
- Director Credentialing
- Phone
- (941) 380-0606
Practitioners 11
-
Mohammed S Akram, MD, MHA
-
Zafia Anklesaria, M.D.
-
Harneet Singh Bath, M.D.
-
Rajan Garg, MD
-
Tao He, M.D., PH.D.
-
Tinofa O Muskwe, M.D.
-
Yasser Omar, M.D.
-
Adam Rizvi, MD
-
Sriram Sambasivan, M.D.
-
Jad Sargi, MD
-
Timothy James Stacy, ACNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220209001401 | CA | Part B Supplier - Clinic/Group Practice | 7012300304 |
Receives reassigned benefits from 11 practitioners Practice locations: Redding, CA |
| O20220304000722 | CA | Part B Supplier - Clinic/Group Practice | 7012300304 |
Receives reassigned benefits from 11 practitioners Practice locations: San Diego, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician |
207RC0200X | Yes |
Addresses
Primary practice location
2445 Ember Mist CT
Las Vegas, NV 89135-1075
Mailing address
5268 Huckleberry Oak St
Simi Valley, CA 93063-4503
Phone (805) 208-0434
NPI Registry JSON
{
"created_epoch": "1642377600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1646265600000",
"number": "1972254332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5268 HUCKLEBERRY OAK ST",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930634503",
"telephone_number": "805-208-0434",
"fax_number": "805-578-2371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2445 EMBER MIST CT",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891351075",
"telephone_number": "805-208-0434"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRIPLEAIM HEALTHCARE",
"organizational_subpart": "NO",
"enumeration_date": "2022-01-17",
"last_updated": "2022-03-03",
"certification_date": "2022-03-03",
"status": "A",
"authorized_official_last_name": "LEE",
"authorized_official_first_name": "CHERYL",
"authorized_official_title_or_position": "DIRECTOR CREDENTIALING",
"authorized_official_telephone_number": "941-380-0606"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Critical Care Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.