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CENTERWELL SENIOR PRIMARY CARE -FREMONT STREET
NPI 1083237465
Internal Medicine in Las Vegas, NV

Active since May 20, 2020CLIA 29D2192479 · Waiver
1766 E CHARLESTON BLVD, LAS VEGAS, NV 89104(702) 843-2440(833) 749-0349 Get Directions Write a Review

NPPES record last updated: July 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 3, 2024, Oct 20, 2022, Apr 9, 2021 and 3 more (6 updates tracked since 2020).

About Centerwell Senior Primary Care -fremont Street NPPES

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

CENTERWELL SENIOR PRIMARY CARE -FREMONT STREET (NPI 1083237465) is a healthcare organization registered as an internal medicine in Las Vegas, Nevada and active in the NPI registry since May 2020. The organization holds a CLIA Waiver certificate valid through September 9, 2026 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1083237465
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE (NV) PC
Location Address1766 E CHARLESTON BLVDLas Vegas, NV 89104-1945
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(702) 843-2440
Fax(833) 749-0349
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateMay 20, 2020
Last NPPES UpdateJuly 3, 20246 updates tracked since enumeration
NPPES CertifiedJuly 3, 2024
✔ NPI 1083237465 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
1766 E CHARLESTON BLVD, Las Vegas, NV 89104
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Other Names 3

Doing Business AsCenterwell Senior Primary Care -fremont Street
Doing Business AsPartners In Primary Care-fremont Street
Former Legal Business NamePartners In Primary Care Nv Pc

Other Identifiers 1

Medicaid250009773NV

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 29D2192479

Centerwell Senior Primary Care - Fremont Street · Las Vegas, NV
Active · expires Sep 9, 2026
CLIA Number29D2192479
Laboratory TypePhysician Office
Certificate Effective DateSeptember 10, 2024
Certificate Expiration DateSeptember 9, 2026
Laboratory DirectorTracy Wakefield
Laboratory Phone(702) 843-2440
Laboratory LocationCenterwell Senior Primary Care - Fremont Street1766 E Charleston Blvd, Las Vegas, NV 89104
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

KORNELIA MIKHATS
Family Medicine
1766 E CHARLESTON BLVD
LAS VEGAS, NV 89104
Clark County (702) 843-2440
DR. CARRIE F ASH-MOTT MD
Family Medicine
1766 E CHARLESTON BLVD
LAS VEGAS, NV 89104
Clark County (702) 843-2440
DR. CHRISTINA HENRY D.O
Family Medicine
1766 E CHARLESTON BLVD
LAS VEGAS, NV 89104
Clark County (702) 843-2440
MR. MICHAEL A WONG D.O.
Internal Medicine
1766 E CHARLESTON BLVD
LAS VEGAS, NV 89104
Clark County (702) 843-2440

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 1083237465. It was assigned to this organization in the NPPES registry on May 20, 2020. The provider is doing business as Centerwell Senior Primary Care -Fremont Street and Partners in Primary Care-Fremont Street. The provider was formerly known as Partners in Primary Care NV PC.

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

Centerwell Senior Primary Care (nv) PC is located at 1766 E Charleston Blvd, Las Vegas, NV 89104. The listed phone number is (702) 843-2440.

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

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

Does Centerwell Senior Primary Care (nv) PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 29D2192479) is associated with this NPI, valid through September 9, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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.