MR. ROBERT GREGORY NYDAM IDMT
NPI 1184867301
Physician Assistant in Las Vegas, NV

Q: What is Robert Nydam's NPI number?

The NPI number for Robert Nydam is 1184867301. It was assigned to this individual provider in the NPPES registry on April 17, 2009.

Q: What is Robert Nydam's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Robert Nydam was last updated on January 23, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 17, 2009PECOS Enrolled

888 S RANCHO DR, LAS VEGAS, NV 89106(702) 877-8600(702) 258-6152 Get Directions Write a Review

NPPES record last updated: January 23, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 23, 2017, Jan 20, 2016, Jan 11, 2016 and 1 more (4 updates tracked since 2015).

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About Mr. Robert Gregory Nydam Idmt NPPES

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

MR. ROBERT GREGORY NYDAM IDMT (NPI 1184867301) is an individual physician assistant in Las Vegas, Nevada and active in the NPI registry since April 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1184867301

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. ROBERT GREGORY NYDAMCredential: IDMT

Location Address888 S RANCHO DRLas Vegas, NV 89106-3810

Mailing AddressPo Box 15645Las Vegas, NV 89114-5645 · (702) 877-8600 · Fax (702) 258-6152

Phone(702) 877-8600

Fax(702) 258-6152

Sole ProprietorNo

Enumeration DateApril 17, 2009

Last NPPES UpdateJanuary 23, 20174 updates tracked since enumeration

✔ NPI 1184867301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedMilitary Health Care Provider · Independent Duty Medical TechniciansTaxonomy 1710I1003X

888 S RANCHO DR, Las Vegas, NV 89106

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Other Identifiers 2

Medicaid1184867301NV

Medicare PINV112613NV

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Robert Gregory Nydam Idmt 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 89106 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

$71.14 typical visit price

range $18.27 – $140.96

Typical copayment $17.78 (range $4.56 – $35.24)

Most-billed visit code 99213

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

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