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ANISA AZAD DO
NPI 1053170530
Student in an Organized Health Care Education/Training Program in Las Vegas, NV

Active since March 18, 2024PECOS Enrolled
2880 N TENAYA WAY, LAS VEGAS, NV 89128(702) 962-9540 Get Directions Write a Review

NPPES record last updated: June 16, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Anisa Azad Do NPPES

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

ANISA AZAD DO (NPI 1053170530) is an individual student in an organized health care education/training program in Las Vegas, Nevada and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS and is a graduate of Touro Un Col Of Osteopathic Medicine, Henderson (2024).

NPPES Registry Identity

NPI1053170530
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameANISA AZADCredential: DO
Location Address2880 N TENAYA WAYLas Vegas, NV 89128-0618
Mailing Address2880 N Tenaya WayLas Vegas, NV 89128-0618 · (702) 962-9540
Phone(702) 962-9540
Sole ProprietorNo
Medical School CMSTouro Un Col Of Osteopathic Medicine, HendersonGraduated 2024
Enumeration DateMarch 18, 2024
Last NPPES UpdateJune 16, 2025
NPPES CertifiedJune 16, 2025
✔ NPI 1053170530 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2880 N TENAYA WAY, Las Vegas, NV 89128
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Anisa Azad Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4082159405
PECOS Enrollment IDI20260817001216
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Anisa Azad reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Smi Imaging LLC
0.8 mi
Diagnostic Radiology
7610 W CHEYENNE AVE STE 100
Las Vegas, NV 89129
  • Reassigned Medicare billing, Nevada enrollment
  • 55 clinicians in this Medicare group
NPI 1396381273 (702) 665-5195

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

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIEL MCRAE BLACKMORE DO
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY
LAS VEGAS, NV 89128
Clark County (702) 235-6630
ERENE YUSTINA ABDELMESEEH MD
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY
LAS VEGAS, NV 89128
Clark County (702) 962-9540
RAGHAVENDRA AKHIL BOGABATHINA
Internal Medicine
2880 N TENAYA WAY
LAS VEGAS, NV 89128
Clark County (702) 962-9540
YUKTI KARKI MD
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY
LAS VEGAS, NV 89128
Clark County (702) 427-6398
YOUSSEF BESHAY
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY
LAS VEGAS, NV 89128
Clark County (725) 377-3655
DR. KENNETH FRANK PEREIRA DO
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY
LAS VEGAS, NV 89128
Clark County (702) 962-9546
NICOLE INFANTINO DO
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY
LAS VEGAS, NV 89128
Clark County (702) 769-5937
RYAN MICHAEL NASH DO
Student in an Organized Health Care Education/Training Program
2880 N TENAYA WAY
LAS VEGAS, NV 89128
Clark County (702) 962-9563

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 Anisa Azad's NPI number?

The NPI number for Anisa Azad is 1053170530. It was assigned to this individual provider in the NPPES registry on March 18, 2024.

Where is Anisa Azad located?

Anisa Azad practices at 2880 N Tenaya Way, Las Vegas, NV 89128. The listed phone number is (702) 962-9540.

What is Anisa Azad's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Anisa Azad enrolled in Medicare?

Yes. Anisa Azad is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Anisa Azad's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Anisa Azad reassigns Medicare benefits to Smi Imaging LLC (Las Vegas, NV). The 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 Anisa Azad's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Anisa Azad was last updated on June 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.