Individual provider Active NPI

William Vontobel, MD

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1992722474
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5099 Issued in NV
Practice address
3150 N Tenaya Way
Suite 100
Las Vegas, NV 89128-0443
Phone
(702) 869-9200
Fax
(702) 216-3821
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5099 NV Primary

Addresses

Primary practice location

3150 N Tenaya Way
Suite 100
Las Vegas, NV 89128-0443

Mailing address

3121 S Maryland Pkwy 204
Las Vegas, NV 89109-2302
Phone (702) 320-3627

Other identifiers 1

IdentifierTypeStateIssuer
002002200MedicaidNV

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
I20100820000068 NV Practitioner - Family Practice 1759415193 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access Primary Care Physicians, Inc. Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Physicians Medical Center Kaufman, LTD PastSince Dec 3, 2015 Accepting new patients

Locations

2870 S Maryland Pkwy
Ste 120
Las Vegas, NV 89109
Phone (702) 456-3120

7190 Smoke Ranch Rd
Ste 150
Las Vegas, NV 89128
Phone (702) 434-7246

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1992722474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 S MARYLAND PKWY 204",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092302",
            "telephone_number": "702-320-3627",
            "fax_number": "702-320-3849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N TENAYA WAY",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280443",
            "telephone_number": "702-869-9200",
            "fax_number": "702-216-3821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONTOBEL",
        "first_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "5099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002002200",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.