Individual provider Active NPI

Anna Harutyunyan, M.D.

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1972930493
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
16640 Issued in NV
Practice address
4750 W Oakey Blvd # 2a
Las Vegas, NV 89102-1535
Phone
(702) 854-2934
NPI assigned
Sep 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 16640 NV Primary

Addresses

Primary practice location

4750 W Oakey Blvd # 2a
Las Vegas, NV 89102-1535

Mailing address

PO Box 15645
Las Vegas, NV 89114-5645
Phone (702) 854-2934

Other identifiers 1

IdentifierTypeStateIssuer
1972930493MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160927000288 NV Practitioner - Internal Medicine 3072800507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

4750 W Oakey Blvd
Las Vegas, NV 89102-1535
Phone (702) 579-3253

Hospital & facility affiliations

  • True Harmony Home Health LLC Home health agency, Las Vegas, NV, CCN 297341

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16640NVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group II Rhodes P C Internal Medicine CurrentSince Jun 3, 2019 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Jun 3, 2019 Accepting new patients
Southwest Medical Associates, Inc Internal Medicine CurrentSince Sep 19, 2016 Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
Henderson Hospital Past Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
North Vista Hospital LLC Past Accepting new patients
Desert View Regional Medical Center Holdings, LLC Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

2704 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 243-8500

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

4750 W Oakey Blvd
Ste 2A
Las Vegas, NV 89102

4750 W Oakey Blvd
#2A
Las Vegas, NV 89102
Phone (702) 854-2934

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4
  • Direct secure messaging: aharutyunyan119178@westdirect.optum.com

Organizations & group practices 9

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

Hospital & facility affiliations 1

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": "1380412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1972930493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "702-854-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 W OAKEY BLVD # 2A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021535",
            "telephone_number": "702-854-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARUTYUNYAN",
        "first_name": "ANNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-29",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "16640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972930493",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.