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CENTERWELL SENIOR PRIMARY CARE-BONANZA
NPI 1003695545
Internal Medicine in Las Vegas, NV

Active since September 25, 2023
691 N NELLIS BLVD, LAS VEGAS, NV 89110(702) 430-9996(877) 409-2125 Get Directions Write a Review

NPPES record last updated: July 3, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Centerwell Senior Primary Care-bonanza NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTERWELL SENIOR PRIMARY CARE-BONANZA (NPI 1003695545) is a healthcare organization registered as an internal medicine in Las Vegas, Nevada and active in the NPI registry since September 2023. The organization lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1003695545
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE (NV) PC
Location Address691 N NELLIS BLVDLas Vegas, NV 89110-5383
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(702) 430-9996
Fax(877) 409-2125
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateSeptember 25, 2023
Last NPPES UpdateJuly 3, 2024
NPPES CertifiedJuly 3, 2024
✔ NPI 1003695545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X
Also ListedGeneral PracticeTaxonomy 208D00000X
691 N NELLIS BLVD, Las Vegas, NV 89110
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Other Names 1

Doing Business AsCenterwell Senior Primary Care-bonanza

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Centerwell Senior Primary Care-bonanza is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

84

Medicare enrollment records show 84 clinicians reassign Medicare billing to Centerwell Senior Primary Care-Bonanza, which bills Medicare for the services they deliver. Of these, 38 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 5

Family Practice31
Nurse Practitioner26
Internal Medicine15
Cardiovascular Disease (Cardiology)11
Cardiac Electrophysiology1

Nearest to this location (20)

See all 84
Alex Ma, MD
Family Practice
NPI 1972180404
4469 W CHARLESTON BLVD
Las Vegas, NV 89102
(702) 637-2114
✔ PECOS✔ Accepts Medicare1.5 mi
Janethe Molina De Pena, APRN,FNP-C
Nurse Practitioner
NPI 1053136937
4469 W CHARLESTON BLVD
Las Vegas, NV 89102
(702) 637-4239
✔ PECOS✔ Accepts Medicare1.5 mi
Ivan Arce-Munoz, M.D.
Family Practice
NPI 1750518908
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare2.7 mi
Michael Chau, FNP-BC
Nurse Practitioner
NPI 1447832688
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare2.7 mi
Flor Guerrero, APRN
Nurse Practitioner
NPI 1144823311
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare2.7 mi
Hayley Kuhn, MD
Family Practice
NPI 1326454307
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare2.7 mi
Stephen Lynn
Family Practice
NPI 1407506066
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare2.7 mi
Maritess Nabong, APRN
Nurse Practitioner
NPI 1174925788
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare2.7 mi
Majonel Ontanillas, MD
Internal Medicine
NPI 1235105313
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare2.7 mi
Tracy Wakefield, MD
Internal Medicine
NPI 1053369827
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare2.7 mi
Cuong La, MD
Family Practice
NPI 1609442821
2335 E LAKE MEAD BLVD
North Las Vegas, NV 89030
(702) 840-2538
✔ PECOS✔ Accepts Medicare3.4 mi
Gabriel Estrada Sotomayor, MD
Family Practice
NPI 1235711326
2335 E LAKE MEAD BLVD
North Las Vegas, NV 89030
(702) 729-6739
✔ PECOS✔ Accepts Medicare3.4 mi
Liuver Rodriguez Marichal
Nurse Practitioner
NPI 1518501295
2335 E LAKE MEAD BLVD
North Las Vegas, NV 89030
(702) 840-2538
✔ PECOS✔ Accepts Medicare3.4 mi
Kornelia Mikhats
Family Practice
NPI 1093128555
1766 E CHARLESTON BLVD
Las Vegas, NV 89104
(702) 843-2440
✔ PECOS✔ Accepts Medicare3.8 mi
Aaron Singh, DO
Internal Medicine
NPI 1235889031
1766 E CHARLESTON BLVD
Las Vegas, NV 89104
(702) 843-2440
✔ PECOS✔ Accepts Medicare3.8 mi
Gregory Desimone, DO
Family Practice
NPI 1851785687
4919 W CRAIG RD
Las Vegas, NV 89130
(725) 220-8706
✔ PECOS✔ Accepts Medicare4.5 mi
Cherielynn Wagner, DO
Family Practice
NPI 1295175271
4919 W CRAIG RD
Las Vegas, NV 89130
(725) 220-8706
✔ PECOS✔ Accepts Medicare4.5 mi
Dorothy May Agdamag, APRN
Nurse Practitioner
NPI 1780195446
4919 W CRAIG RD
Las Vegas, NV 89130
(725) 220-8706
✔ PECOS✔ Accepts Medicare4.5 mi
Karyn Harries, DO
Family Practice
NPI 1376571455
4919 W CRAIG RD
Las Vegas, NV 89130
(725) 220-8706
✔ PECOS✔ Accepts Medicare4.5 mi
Michelle Pelagio, FNP-C
Nurse Practitioner
NPI 1437931920
80 S MARTIN LUTHER KING BLVD STE 100
Las Vegas, NV 89106
(725) 228-4500
✔ PECOS✔ Accepts Medicare5.5 mi
See all 84 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Centerwell Senior Primary Care (nv) PC's NPI number?

The NPI number for Centerwell Senior Primary Care (nv) PC is 1003695545. It was assigned to this organization in the NPPES registry on September 25, 2023. The provider is doing business as Centerwell Senior Primary Care-Bonanza.

Where is Centerwell Senior Primary Care (nv) PC located?

Centerwell Senior Primary Care (nv) PC is located at 691 N Nellis Blvd, Las Vegas, NV 89110. The listed phone number is (702) 430-9996.

What is Centerwell Senior Primary Care (nv) PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Centerwell Senior Primary Care (nv) PC enrolled in Medicare?

Yes. Centerwell Senior Primary Care (nv) PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Centerwell Senior Primary Care (nv) PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 84 clinicians in 5 Medicare specialties reassign their Medicare billing to Centerwell Senior Primary Care (nv) PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (31), Nurse Practitioner (26) and Internal Medicine (15). Of these, 38 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Centerwell Senior Primary Care (nv) PC was last updated on July 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.