DR. ROLAND JAYSON FORMOSO PUA (NPI# 1215009782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215009782 |
| Entity Type | Individual |
| Full Name | DR. ROLAND JAYSON FORMOSO PUA |
| Credential | MD |
| Practice Address |
9460 W Flamingo Rd Suite 120 Las Vegas NV 89147-5742 |
| Mailing Address |
11794 Longworth Rd Las Vegas NV 89135-1323 |
| Practice Telephone | 7026387705 |
| Practice Fax Number | 7026387706 |
| Mailing Telephone | 7026387705 |
| Mailing Fax Number | 7026387706 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2012-09-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
12103 | NV | Allopathic & Osteopathic Physicians |
| Street Address |
9460 W FLAMINGO RD SUITE 120 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89147-5742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114332137 | Rochelle Domingo | Nurse Practitioner | 9460 W Flamingo Rd, Ste. 120, Las Vegas, NV 89147 | 2014-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619593621 | Ata Group Lv | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 10170 W Tropicana Ave Ste 156-211, Las Vegas, NV 89147 | 2020-06-25 |
| 1104474022 | Jacklyn Siagatonu | Behavior Technician | 7125 Grand Montecito Parkway, Las Vegas Nv, N Las Vegas, NV 89147 | 2019-09-04 |
| 1700388253 | Pr Acquisition Corporation | Clinic/Center | 9892 W Flamingo Road, Las Vegas, NV 89147 | 2018-03-01 |
| 1629578836 | Jonathan Balagot Dizon | Optometrist | 4160 S Durango Dr, Las Vegas, NV 89147 | 2018-02-14 |
| 1346751526 | Ignite Teen Treatment, LLC | Clinic/Center | 3722 Lone Mesa Dr, Las Vegas, NV 89147 | 2017-10-16 |
| 1306365275 | Diversified Behavioral Health Services LLC | Community/Behavioral Health | 9636 W.cherokee Ave, Las Vegas, NV 89147 | 2017-09-12 |
| 1356874713 | A8a Personal Care Solution LLC | In Home Supportive Care | 8879 West Flamingo, Ste 101, Las Vegas, NV 89147 | 2017-04-04 |
| 1154782191 | Ma Leah Roble Maravillas | Behavioral Analyst | 9999 W Katie Ave Suite 1313, Las Vegas, NV 89147 | 2016-03-18 |
| 1285010959 | Samantha Lauren Pope | Specialist | 9353 W. Twain Ave, Apt 113, Las Vegas, NV 89147 | 2015-08-05 |
| 1215311980 | Daniel Dorado | Marriage & Family Therapist | 9848 Gallo Dr, Las Vegas, NV 89147 | 2015-07-13 |
| Find all providers in zip 89147 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740766005 | Dr. Don Pepito, LLC | Internal Medicine | 9315 W Sunset Rd Ste 100, Las Vegas, NV 89148-5012 | 2018-07-19 |
| 1780139170 | J & Y Wellness Group Inc | Internal Medicine | 18 Moonfire Dr, Las Vegas, NV 89135-7800 | 2016-08-16 |
| 1265706238 | Touro University | Internal Medicine | 3985 S Pearl St, Regency Palms, Las Vegas, NV 89121-7205 | 2012-03-08 |
| 1548556897 | Sophie Kao Chwa | Internal Medicine | 6900 N.pecos Road, Las Vegas, NV 89086 | 2011-06-24 |
| 1831498526 | Touro University | Internal Medicine | 3890 N. Buffalo Drive, Willow Creek Assisted Living Fac, Las Vegas, NV 89129-8809 | 2011-03-21 |
| 1477852168 | Touro University | Internal Medicine | 8720 W. Flamingo Road, Heritage Springs Senior Living, Las Vegas, NV 89147-8684 | 2011-03-21 |
| 1285933978 | Touro University | Internal Medicine | 9100 W. Desert Inn Ave., Aegis of Las Vegas, Las Vegas, NV 89117-6323 | 2011-03-21 |
| 1205135043 | Touro University | Internal Medicine | 3351 N. Buffalo Dr, Willow Creek Memory Care@buffalo, Las Vegas, NV 89129-6283 | 2011-03-18 |
| 1265731152 | Touro University | Internal Medicine | Willow Creek Al -san Martin, 8374 W. Capovilla Ave, Las Vegas, NV 89113-3305 | 2011-03-18 |
| 1871892885 | Touro University | Internal Medicine | 7230 Gagnier Blvd, Willow Creek Memory Care-san Martin, Las Vegas, NV 89113-4400 | 2011-03-17 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.