DR. AGATHA MATSOS FORMOSO MD
NPI 1124657036
Pediatrics in Las Vegas, NV

Q: What is Agatha Formoso's NPI number?

The NPI number for Agatha Formoso is 1124657036. It was assigned to this individual provider in the NPPES registry on April 2, 2020.

Q: What is Agatha Formoso's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Agatha Formoso was last updated on November 16, 2023. 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.

Active since April 02, 2020PECOS Enrolled

2650 N TENAYA WAY # 308, LAS VEGAS, NV 89128(702) 870-2099(702) 869-5347 Get Directions Write a Review

NPPES record last updated: November 16, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 16, 2023, Apr 2, 2020 (2 updates tracked since 2020).

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About Dr. Agatha Matsos Formoso Md NPPES

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

DR. AGATHA MATSOS FORMOSO MD (NPI 1124657036) is an individual pediatrics provider in Las Vegas, Nevada, licensed in Nevada (24172) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Phoenix.

NPPES Registry Identity

NPI1124657036

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. AGATHA MATSOS FORMOSOCredential: MD

Location Address2650 N TENAYA WAY # 308Las Vegas, NV 89128-1102

Mailing Address6355 S Buffalo Dr Fl 3Las Vegas, NV 89113-2133 · (702) 216-3346

Phone(702) 870-2099

Fax(702) 869-5347

Sole ProprietorNo

Enumeration DateApril 2, 2020

Last NPPES UpdateNovember 16, 20232 updates tracked since enumeration

NPPES CertifiedNovember 16, 2023

✔ NPI 1124657036 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in NV · 24172

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2650 N TENAYA WAY # 308, Las Vegas, NV 89128

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Secondary Practice Location 1

Location 11919 E Thomas RdPhoenix, AZ 85016-7710 · Phone (602) 933-0945

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Agatha Matsos Formoso Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.51 typical visit price

range $57.07 – $173.24

Typical copayment $22.12 (range $14.26 – $43.31)

Most-billed visit code 99203

Established Patient

$100.60 typical visit price

range $18.27 – $140.96

Typical copayment $25.15 (range $4.56 – $35.24)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

DAVID RAFFERTY

Pediatrics

2650 N TENAYA WAY # 308
LAS VEGAS, NV 89128

Clark County (702) 870-2099

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 Agatha Formoso's NPI number?

The NPI number for Agatha Formoso is 1124657036. It was assigned to this individual provider in the NPPES registry on April 2, 2020.

Where is Agatha Formoso located?

Agatha Formoso practices at 2650 N Tenaya Way # 308, Las Vegas, NV 89128. The listed phone number is (702) 870-2099.

What is Agatha Formoso's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Agatha Formoso enrolled in Medicare?

Yes. Agatha Formoso is registered in the Medicare PECOS enrollment system.

What insurance does Agatha Formoso accept?

Health plans from Ambetter from Arizona Complete Health list Agatha Formoso as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Agatha Formoso was last updated on November 16, 2023. 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.