NPIMap

Individual provider Active NPI

Leo J Spaccavento, MD

  • Interventional Cardiology Physician
  • Las Vegas, NV
National Provider Identifier
1982793287
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
6187 Issued in NV
Practice address
4275 Burnham Ave
Suite 220
Las Vegas, NV 89119-5488
Phone
(702) 734-0808
Fax
(702) 734-2650
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 6187 NV Primary

Addresses

Primary practice location

4275 Burnham Ave
Suite 220
Las Vegas, NV 89119-5488

Mailing address

4275 Burnham Ave
Suite 220
Las Vegas, NV 89119-5488
Phone (702) 734-0808

Other identifiers 1

IdentifierTypeStateIssuer
002019086MedicaidNV

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
I20100521000680 NV Practitioner - Cardiovascular Disease (Cardiology) 6002997947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Hahneman Medical College of the Pacific, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4275 Burnham Ave
Suite 220
Las Vegas, NV 89119-5400
Phone 7027340808250

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.27 of 100Reported as individual
Quality
56.71
Improvement activities
40
Cost
65.3

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Springs Hospital Past Accepting new patients
Boulder City Hospital Inc Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: leo.spaccavento.1@30815.direct.athenahealth.com

Organizations & group practices 4

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 9

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1982793287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4275 BURNHAM AVE",
            "address_2": "SUITE 220",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195488",
            "telephone_number": "702-734-0808",
            "fax_number": "702-734-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 BURNHAM AVE",
            "address_2": "SUITE 220",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195488",
            "telephone_number": "702-734-0808",
            "fax_number": "702-734-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPACCAVENTO",
        "first_name": "LEO",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NV",
            "license": "6187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002019086",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.