DR. SHEMROCK OCTAVIO CORDOVA M.D.
NPI 1689647190
Family Medicine in Las Vegas, NV

Q: What is Shemrock Cordova's NPI number?

The NPI number for Shemrock Cordova is 1689647190. It was assigned to this individual provider in the NPPES registry on February 8, 2006.

Q: What is Shemrock Cordova's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Shemrock Cordova was last updated on December 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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 08, 2006PECOS EnrolledAccepts Medicare Assignment

4760 BLUE DIAMOND RD STE 110, LAS VEGAS, NV 89139(702) 383-2300 Get Directions Write a Review

NPPES record last updated: December 19, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 19, 2024, Sep 7, 2018 (2 updates tracked since 2018).

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About Dr. Shemrock Octavio Cordova M.d. NPPES

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

DR. SHEMROCK OCTAVIO CORDOVA M.D. (NPI 1689647190) is an individual family medicine provider in Las Vegas, Nevada, licensed in Nevada (10709) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1983).

NPPES Registry Identity

NPI1689647190

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. SHEMROCK OCTAVIO CORDOVACredential: M.D.

Location Address4760 BLUE DIAMOND RD STE 110Las Vegas, NV 89139-7665

Mailing Address1800 W Charleston BlvdLas Vegas, NV 89102-2386 · (702) 383-2000

Phone(702) 383-2300

Sole ProprietorNo

Medical School CMSOtherGraduated 1983

Enumeration DateFebruary 8, 2006

Last NPPES UpdateDecember 19, 20242 updates tracked since enumeration

NPPES CertifiedDecember 19, 2024

✔ NPI 1689647190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NV · 10709

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

4760 BLUE DIAMOND RD STE 110, Las Vegas, NV 89139

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Shemrock Octavio Cordova M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921996265

PECOS Enrollment IDI20040326001190

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.

Medicare Billing Reassignments

Medicare enrollment records show Shemrock Cordova reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Medical Center Of Southern Nevada

Same address

Urgent Care

4760 BLUE DIAMOND RD STE 110
Las Vegas, NV 89139

Reassigned Medicare billing, Nevada enrollment
522 clinicians in this Medicare group

NPI 1710549829 (702) 383-2300

Meilan L Daguman Aprn PLLC

6.9 mi

Primary Care

4560 S EASTERN AVE STE 15
Las Vegas, NV 89119

Reassigned Medicare billing, Nevada enrollment
8 clinicians in this Medicare group

NPI 1023568037 (702) 994-7267

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

53 services45 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

27 services27 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

19 services19 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

13 services11 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89139 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 4

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

STEVEN MICHAEL GISH PA-C

Physician Assistant

4760 BLUE DIAMOND RD STE 110
LAS VEGAS, NV 89139

Clark County (702) 383-2300

UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA

Clinic/Center (Urgent Care)

4760 BLUE DIAMOND RD STE 110
LAS VEGAS, NV 89139

Clark County (702) 383-2300

CHRISTOPHER KEGAN DO

Family Medicine

4760 BLUE DIAMOND RD STE 110
LAS VEGAS, NV 89139

Clark County (702) 383-2300

PAUL SON M.D.

Family Medicine

4760 BLUE DIAMOND RD STE 110
LAS VEGAS, NV 89139

Clark County (702) 383-2300

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 Shemrock Cordova's NPI number?

The NPI number for Shemrock Cordova is 1689647190. It was assigned to this individual provider in the NPPES registry on February 8, 2006.

Where is Shemrock Cordova located?

Shemrock Cordova practices at 4760 Blue Diamond Rd Ste 110, Las Vegas, NV 89139. The listed phone number is (702) 383-2300.

What is Shemrock Cordova's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shemrock Cordova enrolled in Medicare?

Yes. Shemrock Cordova is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Shemrock Cordova's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shemrock Cordova reassigns Medicare benefits to 2 organizations: University Medical Center Of Southern Nevada (Las Vegas, NV) and Meilan L Daguman Aprn PLLC (Las Vegas, NV). Each 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 Shemrock Cordova's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shemrock Cordova accept?

Health plans from Molina Healthcare list Shemrock Cordova 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 Shemrock Cordova was last updated on December 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.