FREMONT EMERGENCY SERVICES MANDAVIA LTD (NPI# 1366429821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366429821 |
| Entity Type | Organization |
| Organization Name | FREMONT EMERGENCY SERVICES MANDAVIA LTD |
| Other Organization Name | FREMONT EMERGENCY SERVICES (MANDAVIA), LTD. |
| Practice Address |
3100 N Tenaya Way Las Vegas NV 89128-0436 |
| Mailing Address |
5000 Hopyard Rd Ste 100 Pleasanton CA 94588-3146 |
| Practice Telephone | 7022555025 |
| Practice Fax Number | 7026716883 |
| Mailing Telephone | 9259241600 |
| Mailing Fax Number | 9259240506 |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2020-01-10 |
| Authorized Official Name | SHARON HARDY (DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 9252516901 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 1366429821 | 05 |
| Other Name | Type Code |
|---|---|
| Fremont Emergency Services (Henner and Sears) Ltd. | Former Legal Business Name - Organization |
| Fremont Emergency Services (Mandavia), Ltd. | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316488141 | Fremont Emergency Services Mandavia Ltd | Physician Assistant | 7207 Aliante Parkway, North Las Vegas, NV 89128-0436 | 2017-03-13 |
| 1679550149 | Fremont Emergency Services Mandavia Ltd | Physician Assistant | 9300 W Sunset Rd, Las Vegas, NV 89148-4844 | 2005-12-27 |
| 1689013161 | Fremont Emergency Services Mandavia Ltd | Emergency Medicine | 3001 Saint Rose Pkwy, Henderson, NV 89052-3839 | 2013-06-18 |
| 1518120971 | Fremont Emergency Services Mandavia Ltd | Physician Assistant | 3186 S Maryland Pkwy, Las Vegas, NV 89109-2317 | 2008-07-07 |
| Street Address |
3100 N TENAYA WAY |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89128-0436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124021175 | Dana L Trippi | Emergency Medicine | 3100 N Tenaya Way, Las Vegas, NV 89128-0436 | 2005-05-23 |
| 1255960191 | Ara G Amirkhanian | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way, Las Vegas, NV 89128-0436 | 2020-04-03 |
| 1497384283 | Tyler B Miller | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way, Las Vegas, NV 89128-0436 | 2020-04-03 |
| 1043848146 | Nathaly Quinteros | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way, Las Vegas, NV 89128-0436 | 2020-04-01 |
| 1477181568 | Connor Alfred Frost | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way, Las Vegas, NV 89128-0436 | 2020-04-01 |
| 1992333207 | Adrian Christopher Espe Dris | Registered Nurse | 3100 N Tenaya Way, Las Vegas, NV 89128-0436 | 2020-03-31 |
| 1427686104 | Aushin Francis | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way, Graduate Medical Education, Las Vegas, NV 89128-0431 | 2020-03-30 |
| 1588292197 | Gunnar Lyle Whealy | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way, Las Vegas, NV 89128-0436 | 2020-03-30 |
| 1801424577 | Richard Liang Wang | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way, Las Vegas, NV 89128-0436 | 2020-03-30 |
| 1558999243 | Neal Kwame Ekpoudia | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way, Las Vegas, NV 89128-0436 | 2020-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374256 | Dmc Medical Clinic Ltd | Family Medicine | 7140 Smoke Ranch Road, 150, Las Vegas, NV 89128 | 2020-10-23 |
| 1619589462 | Eldercare Services Lv, LLC | Technician | 8430 W. Lake Mead Blvd Suite 100, Las Vegas, NV 89128 | 2020-08-21 |
| 1508477308 | Amneris Lizet Duran-brocato | Technician | 1150 North Buffalo Dr. Apt 2120, Las Vegas, NV 89128 | 2020-08-14 |
| 1366082612 | Ar Home Health Management LLC | Home Health | 7465 W Lake Mead Blvd Suite 100, Las Vegas, NV 89128 | 2020-01-14 |
| 1114563731 | Leslie A Pasternack | Acupuncturist | Integrated Acupuncture of Southern Nevada, 7250 Peak Dr #106, Las Vegas, NV 89128 | 2019-11-19 |
| 1154977940 | Devora Susana Leon-lopez | Chore Provider | 7320 Smoke Ranch Rd. Ste. H, Las Vegas, NV 89128 | 2019-08-16 |
| 1659924884 | Blanca Estela Garnica-mendez | Chore Provider | 7320 Smoke Ranch Rd. Suite H, Suite H, Las Vegas, NV 89128 | 2019-07-17 |
| 1467913160 | Sherwin Necunazar Azad | Student in an Organized Health Care Education/Training Program | Mountainview Hospital Gme, 3100 N. Tenaya Way, Las Vegas, NV 89128 | 2019-03-26 |
| 1962963801 | Michael Richard Korczynski | Student in an Organized Health Care Education/Training Program | 3100 North Tenaya Way, Las Vegas, NV 89128 | 2019-03-25 |
| 1013477041 | Yuanlong Zhao | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way Graduate Medical Education, Las Vegas, NV 89128 | 2019-03-25 |
| Find all providers in zip 89128 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578180469 | Athlete Advantage Medical | Emergency Medicine | 6771 W Charleston Blvd Ste B, Las Vegas, NV 89146-9016 | 2020-06-26 |
| 1588219117 | Spring Valley Medical Center | Emergency Medicine | 9217 S Cimarron Rd, Las Vegas, NV 89178 | 2019-08-09 |
| 1245740133 | Insight Medical Associates LLC | Emergency Medicine | 500 N Rainbow Blvd Ste 300-230, Las Vegas, NV 89107-1082 | 2017-10-04 |
| 1912438763 | Dominic Diprinzio | Emergency Medicine | 901 Ranch Lane, Suite 135, Las Vegas, NV 89106 | 2017-03-23 |
| 1740643998 | Ryan Patrick Casarella | Emergency Medicine | 653 N Town Center Dr # 657, Las Vegas, NV 89144-0514 | 2016-04-04 |
| 1437548906 | Clinic 21 of Nevada Zyniewicz Pllc | Emergency Medicine | 5216 Boulder Hwy, Suite 105, Las Vegas, NV 89122-6074 | 2015-01-21 |
| 1114189917 | Stephanos Paraskevas Orphanidis | Emergency Medicine | 8670 W Cheyenne Ave Ste 120, Maimonides Medical Center Department of Emergency Med, Las Vegas, NV 89129-7457 | 2008-07-02 |
| 1104011527 | Joeann K Leong | Emergency Medicine | 8670 West Cheyenne Avenue, Suite 120, Las Vegas, NV 89129 | 2007-09-10 |
| 1376741256 | Jack Sui Ki Chan | Emergency Medicine | 1350 N Town Center Dr Unit 1033, Las Vegas, NV 89144-0577 | 2007-07-03 |
| 1700087392 | Jason Donovan Klein | Emergency Medicine | 9880 W Flamingo Rd, Las Vegas, NV 89147-8085 | 2007-05-30 |
| 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.