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CENTERWELL SENIOR PRIMARY CARE-BOULDER HIGHWAY
NPI 1831765692
Internal Medicine in Las Vegas, NV

Active since June 02, 2021CLIA 29D2247859 · Waiver
6360 BOULDER HWY, LAS VEGAS, NV 89122(725) 228-4520(877) 889-5390 Get Directions Write a Review

NPPES record last updated: February 15, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 11, 2023, Oct 20, 2022, Jun 2, 2021 (3 updates tracked since 2021).

About Centerwell Senior Primary Care-boulder Highway NPPES

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

CENTERWELL SENIOR PRIMARY CARE-BOULDER HIGHWAY (NPI 1831765692) 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

NPI1831765692
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE (NV) PC
Location Address6360 BOULDER HWYLas Vegas, NV 89122-7301
Mailing Address4700 Millenia Blvd Ste 650Orlando, FL 32839-6013 · (407) 447-7120 · Fax (407) 770-0661
Phone(725) 228-4520
Fax(877) 889-5390
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateJune 2, 2021
Last NPPES UpdateFebruary 15, 20243 updates tracked since enumeration
NPPES CertifiedFebruary 15, 2024
✔ NPI 1831765692 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ 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 ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X
Also ListedGeneral PracticeTaxonomy 208D00000X
6360 BOULDER HWY, Las Vegas, NV 89122
Open in Google Maps ↗

Other Names 1

Doing Business AsCenterwell Senior Primary Care-boulder Highway

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

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 29D2247859

Centerwell Senior Primary Care-Boulder Hwy · Las Vegas, NV
Active · expires Jan 9, 2028
CLIA Number29D2247859
Laboratory TypePhysician Office
Certificate Effective DateJanuary 10, 2026
Certificate Expiration DateJanuary 9, 2028
Laboratory DirectorTracy Wakefield
Laboratory Phone(725) 228-4520
Laboratory LocationCenterwell Senior Primary Care-Boulder Hwy6360 Boulder Hwy, Las Vegas, NV 89122
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

JOYCE CARLOS DAMIANO APRN, MSN, FNP-BC
Nurse Practitioner (Family)
6360 BOULDER HWY
LAS VEGAS, NV 89122
Clark County (725) 228-4520
DR. CHARLES A WILSON D.O.
Family Medicine
6360 BOULDER HWY
LAS VEGAS, NV 89122
Clark County (725) 228-4520
KRUPA UDAY SHAH PA-C
Physician Assistant (Medical)
6360 BOULDER HWY
LAS VEGAS, NV 89122
Clark County (725) 228-4520
LEILA R. OLIVERA MD
Internal Medicine
6360 BOULDER HWY
LAS VEGAS, NV 89122
Clark County (725) 228-4520
MISS PAMELA LOIS BELLOW FNP
Nurse Practitioner
6360 BOULDER HWY
LAS VEGAS, NV 89122
Clark County (725) 228-4520
DR. FUZHAN PARHIZGAR M.D.
Internal Medicine
6360 BOULDER HWY
LAS VEGAS, NV 89122
Clark County (725) 228-4520

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) PC's NPI number?

The NPI number for Centerwell Senior Primary Care (nv) PC is 1831765692. It was assigned to this organization in the NPPES registry on June 2, 2021. The provider is doing business as Centerwell Senior Primary Care-Boulder Highway.

Where is Centerwell Senior Primary Care (nv) PC located?

Centerwell Senior Primary Care (nv) PC is located at 6360 Boulder Hwy, Las Vegas, NV 89122. The listed phone number is (725) 228-4520.

What is Centerwell Senior Primary Care (nv) PC's specialty?

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

Does Centerwell Senior Primary Care (nv) PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 29D2247859) 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 February 15, 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.