MICHAEL J PETRUSO M.D.
NPI 1336112382
Internal Medicine in Las Vegas, NV

Q: What is Michael Petruso's NPI number?

The NPI number for Michael Petruso is 1336112382. It was assigned to this individual provider in the NPPES registry on February 9, 2006.

Q: What is Michael Petruso's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Michael Petruso was last updated on October 28, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 February 09, 2006

2704 N TENAYA WAY, SUITE 400, LAS VEGAS, NV 89128(702) 243-8500 Get Directions Write a Review

NPPES record last updated: October 28, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Michael J Petruso M.d. NPPES

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

MICHAEL J PETRUSO M.D. (NPI 1336112382) is an individual internal medicine provider in Las Vegas, Nevada, licensed in Nevada (6283) and active in the NPI registry since February 2006.

NPPES Registry Identity

NPI1336112382

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameMICHAEL J PETRUSOCredential: M.D.

Location Address2704 N TENAYA WAY, SUITE 400Las Vegas, NV 89128-0424

Mailing AddressPo Box 15645, Suite 150Las Vegas, NV 89114-5645 · (702) 243-8500

Phone(702) 243-8500

Sole ProprietorNo

Enumeration DateFebruary 9, 2006

Last NPPES UpdateOctober 28, 2014

✔ NPI 1336112382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NV · 6283

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.

2704 N TENAYA WAY, Las Vegas, NV 89128

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Other Identifiers 7

Other1336112382NV · Sma Medicaid

Medicare PIN11WCGZT06NV

OtherV24262NV · Lab

OtherV108716NV · Sma Medicare

OtherVWCGZTNV · Medicare Group

Medicaid2019102NV

Medicare UPINE85048NV

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.

PATRICIA MAY B. LACSINA M.D.

Family Medicine