Active NPI
Gary A. Peitzmeier, M.D.
- Surgery Physician
- Nellis Afb, NV
National Provider Identifier
1992791917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 17673
- Practice address
- 4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600 - Phone
- (702) 653-3050
- NPI assigned
- Sep 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 35.096963 | OH | |
| Surgery Physician | 208600000X | 17673 | NV | Primary |
Addresses
Primary practice location
4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Mailing address
4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Phone (702) 653-3050
Other practice location 1
Unlv Medicine
1701 W Charleston Blvd Suite 100
Las Vegas, NV 89102
Phone (702) 671-5005
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35.096963 | Other | OH | OHIO STATE LICENSING BOARD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17673 | NV | MD | Surgery Physician |
| 35.096963 | OH | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1992791917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 LAS VEGAS BLVD N",
"city": "NELLIS AFB",
"state": "NV",
"postal_code": "891916600",
"telephone_number": "702-653-3050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 LAS VEGAS BLVD N",
"city": "NELLIS AFB",
"state": "NV",
"postal_code": "891916600",
"telephone_number": "702-653-3050"
}
],
"practiceLocations": [
{
"address_1": "UNLV MEDICINE",
"address_2": "1701 W Charleston Blvd Suite 100",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "89102",
"country_code": "US",
"telephone_number": "702-671-5005",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEITZMEIER",
"first_name": "GARY",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-26",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OH",
"license": "35.096963",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NV",
"license": "17673",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO STATE LICENSING BOARD",
"identifier": "35.096963",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nellis Afb, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.