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CENTERWELL SENIOR PRIMARY CARE NV CS PC
NPI 1801682257
Internal Medicine in Las Vegas, NV

Active since April 15, 2025
4001 S DECATUR BLVD STE 25, LAS VEGAS, NV 89103(725) 224-6967 Get Directions Write a Review

NPPES record last updated: July 23, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Centerwell Senior Primary Care Nv Cs Pc NPPES

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

CENTERWELL SENIOR PRIMARY CARE NV CS PC (NPI 1801682257) is a healthcare organization registered as an internal medicine in Las Vegas, Nevada and active in the NPI registry since April 2025. The organization maintains a secondary practice location in Miami and lists Angie S Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1801682257
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE NV CS PC
Location Address4001 S DECATUR BLVD STE 25Las Vegas, NV 89103-5857
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (407) 447-7120
Phone(725) 224-6967
Organization SubpartNo
Authorized OfficialAngie S MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateApril 15, 2025
Last NPPES UpdateJuly 23, 2025
NPPES CertifiedJuly 23, 2025
✔ NPI 1801682257 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
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.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedGeneral PracticeTaxonomy 208D00000X
4001 S DECATUR BLVD STE 25, Las Vegas, NV 89103
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Secondary Practice Location 1

Location 16101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · Phone (407) 447-7120

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 Nv Cs Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Centerwell Senior Primary Care Nv Cs PC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Tracy Wakefield, MD
Internal Medicine
NPI 1053369827
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare8.1 mi
Christina Henry, D.O
Family Practice
NPI 1629412002
2500 ANTHEM VILLAGE DR STE 100
Henderson, NV 89052
(702) 843-1437
✔ PECOS✔ Accepts Medicare11 mi

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

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 Centerwell Senior Primary Care Nv Cs PC's NPI number?

The NPI number for Centerwell Senior Primary Care Nv Cs PC is 1801682257. It was assigned to this organization in the NPPES registry on April 15, 2025.

Where is Centerwell Senior Primary Care Nv Cs PC located?

Centerwell Senior Primary Care Nv Cs PC is located at 4001 S Decatur Blvd Ste 25, Las Vegas, NV 89103. The listed phone number is (725) 224-6967.

What is Centerwell Senior Primary Care Nv Cs PC's specialty?

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

Is Centerwell Senior Primary Care Nv Cs PC enrolled in Medicare?

Yes. Centerwell Senior Primary Care Nv Cs PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Centerwell Senior Primary Care Nv Cs PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Centerwell Senior Primary Care Nv Cs PC, in Family Practice and Internal Medicine. 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. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Centerwell Senior Primary Care Nv Cs PC was last updated on July 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.