CENTERWELL SENIOR PRIMARY CARE-SOUTH MLK
NPI 1215503065
Internal Medicine in Las Vegas, NV
About Centerwell Senior Primary Care-south Mlk NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CENTERWELL SENIOR PRIMARY CARE-SOUTH MLK (NPI 1215503065) is a healthcare organization registered as an internal medicine in Las Vegas, Nevada and active in the NPI registry since June 2021. The organization holds a CLIA Waiver certificate valid through January 9, 2028 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Other Names 1
Group Practice 1
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-south Mlk is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
84Medicare enrollment records show 84 clinicians reassign Medicare billing to Centerwell Senior Primary Care-South Mlk, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 61 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 5
Nearest to this location (20)
See all 84Las Vegas, NV 89106
Las Vegas, NV 89106
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 29D2247891
Centerwell Senior Primary Care-S Mlk · Las Vegas, NVFrequently 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 1215503065. It was assigned to this organization in the NPPES registry on June 2, 2021. The provider is doing business as Centerwell Senior Primary Care-South Mlk.
Where is Centerwell Senior Primary Care (nv) PC located?
Centerwell Senior Primary Care (nv) PC is located at 80 S Martin Luther King Blvd Ste 100, Las Vegas, NV 89106. The listed phone number is (725) 228-4500.
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, 2 practice at this address and 61 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Centerwell Senior Primary Care (nv) PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 29D2247891) is associated with this NPI, valid through January 9, 2028. 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.
# Centerwell Senior Primary Care-South Mlk · NPI 1215503065
Internal Medicine organization in Las Vegas, Nevada. Organization record, active in the CMS NPPES registry since June 2, 2021.
## Identity
- **NPI:** 1215503065 (Entity type: Organization)
- **Enumerated:** June 2, 2021
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Legal business name:** Centerwell Senior Primary Care (nv) Pc
- **Organization subpart:** Yes (part of Centerwell Senior Primary Care (nv) Pc)
- **Authorized official:** Angie Martinez, SENIOR CREDENTIALING PROFESSIONAL
## Practice location
- **Address:** 80 S MARTIN LUTHER KING BLVD STE 100, Las Vegas, NV 89106-4325
- **Phone:** (725) 228-4500 · **Fax:** (877) 889-2823
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 84 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (31), Nurse Practitioner (26), Internal Medicine (15); 2 practice at this address and 61 within 10 miles; [full list](https://npiprofile.com/npi/1215503065/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 3, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1215503065) · Data from the CMS NPPES public registry.