Individual provider Active NPI

Diego Acosta, PHARM D.

  • Pharmacist
  • Las Vegas, NV
National Provider Identifier
1992309975
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20689 Issued in NV
Practice address
4391 E Washington Ave
Las Vegas, NV 89110-5715
Phone
(702) 452-2937
NPI assigned
Nov 30, 2020
Last updated
Nov 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20689 NV Primary

Addresses

Primary practice location

4391 E Washington Ave
Las Vegas, NV 89110-5715

Mailing address

5880 Boulder Falls St Apt 2026
Henderson, NV 89011-4933
Phone (702) 812-2366

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL RxConnect

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
20689NVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1992309975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 BOULDER FALLS ST APT 2026",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890114933",
            "telephone_number": "702-812-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4391 E WASHINGTON AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891105715",
            "telephone_number": "702-452-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "DIEGO",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "20689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "RxConnect",
            "affiliation": "N",
            "address_1": "4391 E Washington Ave",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891105715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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 Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.