PISESPONG PATAMASUCON M.D.
NPI 1790763415
Pediatrics - Pediatric Infectious Diseases in Las Vegas, NV

Q: What is Pisespong Patamasucon's NPI number?

The NPI number for Pisespong Patamasucon is 1790763415. It was assigned to this individual provider in the NPPES registry on January 3, 2006.

Q: What is Pisespong Patamasucon's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Infectious Diseases, with taxonomy code 2080P0208X.

Active since January 03, 2006PECOS Enrolled

1524 PINTO LN FL 3, LAS VEGAS, NV 89106(702) 944-2828(702) 944-2852 Get Directions Write a Review

NPPES record last updated: February 10, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Feb 10, 2025, May 9, 2023, Mar 7, 2023 and 3 more (6 updates tracked since 2016).

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About Pisespong Patamasucon M.d. NPPES

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

PISESPONG PATAMASUCON M.D. (NPI 1790763415) is an individual pediatric infectious diseases provider in Las Vegas, Nevada, licensed in Nevada (9696) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Denver.

NPPES Registry Identity

NPI1790763415

Entity TypeIndividualMale

Primary Taxonomy2080P0208X

Provider Legal NamePISESPONG PATAMASUCONCredential: M.D.

Location Address1524 PINTO LN FL 3Las Vegas, NV 89106-4195

Mailing Address3016 W Charleston Blvd Ste 100Las Vegas, NV 89102-1973 · (702) 780-2315 · Fax (702) 895-1014

Phone(702) 944-2828

Fax(702) 944-2852

Sole ProprietorNo

Enumeration DateJanuary 3, 2006

Last NPPES UpdateFebruary 10, 20256 updates tracked since enumeration

NPPES CertifiedFebruary 10, 2025

✔ NPI 1790763415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Infectious DiseasesAllopathic & Osteopathic Physicians

Taxonomy Code2080P0208X

Licenses✔ Licensed in NV · 9696✔ Licensed in CO · 56251

Definition

A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments.

1524 PINTO LN FL 3, Las Vegas, NV 89106

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Secondary Practice Location 1

Location 12055 N High St Ste 380Denver, CO 80205-5503 · Phone (303) 393-4300 · Fax (303) 832-7205

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 (PECOS)

Pisespong Patamasucon M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Pisespong Patamasucon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Unlv Medicine

1.2 mi

Internal Medicine

3016 W CHARLESTON BLVD STE 100
Las Vegas, NV 89102

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

NPI 1407397235 (702) 895-0497

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

Other Providers at the Same Location NPPES 18

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

DR. TIMOTHY MICHAEL GOLIA JR. DO

Student in an Organized Health Care Education/Training Program