NPIMap

Organization Active NPI

Las Vegas Kidney & Hypertension Specialists LLC

  • Nephrology Physician
  • Henderson, NV
National Provider Identifier
1992130090
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
13545 Issued in NV
Legal business name
LAS VEGAS KIDNEY & HYPERTENSION SPECIALISTS LLC
Practice address
229 N Pecos Rd Ste 120
Henderson, NV 89074-7364
Phone
(702) 256-3637
Fax
(702) 629-7519
NPI assigned
Sep 8, 2013
Last updated
Dec 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Authorized official

Name
Dijana Jefic, M.D.NPI 1730134057
Title
Managing Member
Phone
(702) 818-9246

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 13545 NV Primary

Addresses

Primary practice location

229 N Pecos Rd Ste 120
Henderson, NV 89074-7364

Mailing address

PO Box 778435
Henderson, NV 89077-8435
Phone (702) 818-9246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140505002135 NV Part B Supplier - Clinic/Group Practice 6507099132 Receives reassigned benefits from 6 practitioners
Practice locations: Las Vegas, NV; Henderson, NV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1378598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1992130090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778435",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890778435",
            "telephone_number": "702-818-9246",
            "fax_number": "702-492-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 N PECOS RD STE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747364",
            "telephone_number": "702-256-3637",
            "fax_number": "702-629-7519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS VEGAS KIDNEY & HYPERTENSION SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-08",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "JEFIC",
        "authorized_official_first_name": "DIJANA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "702-818-9246",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NV",
            "license": "13545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.