Organization Active NPI

Healthwell Medical Group

  • Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1972669661
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
10006 Issued in NV
Legal business name
HEALTHWELL MEDICAL GROUP
Practice address
4375 S Buffalo Dr
#101
Las Vegas, NV 89147
Phone
(702) 894-9422
Fax
(702) 894-9258
NPI assigned
Dec 28, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Grace Cano Debelen, MDNPI 1679599013
Title
Doctor Office Manager
Phone
(702) 894-9422

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10005 NV
Pediatrics Physician 208000000X 10006 NV Primary

Addresses

Primary practice location

4375 S Buffalo Dr
#101
Las Vegas, NV 89147

Mailing address

PO Box 82277
Las Vegas, NV 89180
Phone (702) 894-9422

Other names 1

  • Healthwell Medical Group De Belen PC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040712001408 NV Part B Supplier - Clinic/Group Practice 6507844834 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

2121 E Flamingo Rd
Las Vegas, NV 89119
Phone (702) 894-9428

4375 S Buffalo Dr
Ste 101
Las Vegas, NV 89147
Phone (702) 894-9422

Practitioners & affiliated clinicians

Practitioners 2

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": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1972669661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82277",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89180",
            "telephone_number": "702-894-9422",
            "fax_number": "702-894-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 S BUFFALO DR",
            "address_2": "#101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89147",
            "telephone_number": "702-894-9422",
            "fax_number": "702-894-9258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHWELL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "CANO DEBELEN",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "DOCTOR OFFICE MANAGER",
        "authorized_official_telephone_number": "702-894-9422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "10005",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "10006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthwell Medical Group De Belen PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Sep 11, 2025; 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.