NPIMap

Organization Active NPI

Kittusamy LLC

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1972714970
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
KITTUSAMY LLC
Practice address
7500 Smoke Ranch Rd
Suite 100
Las Vegas, NV 89128-0324
Phone
(702) 254-5004
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Authorized official

Name
Maria Martinez
Title
Billing Supervisor
Phone
(702) 254-5004

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

7500 Smoke Ranch Rd
Suite 100
Las Vegas, NV 89128-0324

Mailing address

7660 W Cheyenne Ave Ste 112
Las Vegas, NV 89129-6757
Phone (702) 254-5004

Other practice location 1

7660 W Cheyenne Ave Ste 112
Las Vegas, NV 89129-6757
Phone (702) 254-5004

Other names 2

  • Las Vegas Radiology Doing business as
  • Las Vegas Radiology / Las Vegas Cardiology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080213000131 NV Part B Supplier - Clinic/Group Practice 8820171911 Receives reassigned benefits from 14 practitioners
10 other NPIs on this enrollment
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory
Tax ID family
Kittusamy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7241 W Sahara Ave
Ste 120
Las Vegas, NV 89117

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1972714970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7660 W CHEYENNE AVE STE 112",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296757",
            "telephone_number": "702-254-5004",
            "fax_number": "702-685-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 SMOKE RANCH RD",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280324",
            "telephone_number": "702-254-5004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7660 W Cheyenne Ave Ste 112",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891296757",
            "country_code": "US",
            "telephone_number": "702-254-5004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KITTUSAMY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "702-254-5004"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Las Vegas Radiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Las Vegas Radiology / Las Vegas Cardiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Las Vegas Radiology / Las Vegas Cardiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 1, 2021; 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.