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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: October 25, 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

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-boulder Highway is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

84

Medicare enrollment records show 84 clinicians reassign Medicare billing to Centerwell Senior Primary Care-Boulder Highway, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 46 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 5

Family Practice31
Nurse Practitioner26
Internal Medicine15
Cardiovascular Disease (Cardiology)11
Cardiac Electrophysiology1

Nearest to this location (20)

See all 84
Alexander Abesamis, APRN-RX
Nurse Practitioner
NPI 1164902185
6360 BOULDER HWY
Las Vegas, NV 89122
(725) 228-4520
✔ PECOS✔ Accepts MedicareSame address
Leila Olivera, MD
Internal Medicine
NPI 1619049426
6360 BOULDER HWY
Las Vegas, NV 89122
(725) 228-4520
✔ PECOS✔ Accepts MedicareSame address
Fuzhan Parhizgar, M.D.
Internal Medicine
NPI 1881993343
6360 BOULDER HWY
Las Vegas, NV 89122
(725) 228-4520
✔ PECOS✔ Accepts MedicareSame address
Robert Russ, M.D.
Internal Medicine
NPI 1225008501
1501 W SUNSET RD
Henderson, NV 89014
(725) 269-7001
✔ PECOS✔ Accepts Medicare1.8 mi
Heather Harvey, MPA, MSN, FNP-C
Nurse Practitioner
NPI 1801309919
390 W LAKE MEAD PKWY STE 120
Henderson, NV 89015
(725) 220-8477
✔ PECOS✔ Accepts Medicare3.8 mi
Angela Ortega-Bermudez, DO
Internal Medicine
NPI 1982873360
390 W LAKE MEAD PKWY STE 12
Henderson, NV 89015
(725) 220-8477
✔ PECOS✔ Accepts Medicare3.8 mi
Stephanie Velasquez, MD
Family Practice
NPI 1225787542
390 W LAKE MEAD PKWY STE 120
Henderson, NV 89015
(725) 220-8477
✔ PECOS✔ Accepts Medicare3.8 mi
Demian Gitnacht, M.D.
Family Practice
NPI 1679899579
390 W LAKE MEAD PKWY STE 120
Henderson, NV 89015
(725) 220-8477
✔ PECOS✔ Accepts Medicare3.8 mi
Seyed Mirabbasi, M.D
Internal Medicine
NPI 1427449297
390 W LAKE MEAD PKWY STE 120
Henderson, NV 89015
(725) 220-8477
✔ PECOS✔ Accepts Medicare3.8 mi
Masoud Bitarafan, MD
Internal Medicine
NPI 1376235226
3265 E TROPICANA AVE STE B
Las Vegas, NV 89121
(702) 840-2583
✔ PECOS✔ Accepts Medicare4.1 mi
Matthew Martini, FNP-BC
Nurse Practitioner
NPI 1760154264
3265 E TROPICANA AVE STE B
Las Vegas, NV 89121
(702) 840-2583
✔ PECOS✔ Accepts Medicare4.1 mi
Marilou Sorensen, NP
Nurse Practitioner
NPI 1265139893
3265 E TROPICANA AVE STE B
Las Vegas, NV 89121
(855) 226-6633
✔ PECOS✔ Accepts Medicare4.1 mi
Harry Strothers, MD
Family Practice
NPI 1861492720
3265 E TROPICANA AVE STE B
Las Vegas, NV 89121
(702) 840-2583
✔ PECOS✔ Accepts Medicare4.1 mi
Ivan Arce-Munoz, M.D.
Family Practice
NPI 1750518908
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare4.1 mi
Michael Chau, FNP-BC
Nurse Practitioner
NPI 1447832688
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare4.1 mi
Flor Guerrero, APRN
Nurse Practitioner
NPI 1144823311
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare4.1 mi
Hayley Kuhn, MD
Family Practice
NPI 1326454307
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare4.1 mi
Stephen Lynn
Family Practice
NPI 1407506066
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare4.1 mi
Maritess Nabong, APRN
Nurse Practitioner
NPI 1174925788
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare4.1 mi
Majonel Ontanillas, MD
Internal Medicine
NPI 1235105313
2875 S NELLIS BLVD STE 3
Las Vegas, NV 89121
(702) 843-2420
✔ PECOS✔ Accepts Medicare4.1 mi
See all 84 clinicians

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

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.

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.

Is Centerwell Senior Primary Care (nv) PC enrolled in Medicare?

Yes. Centerwell Senior Primary Care (nv) PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Centerwell Senior Primary Care (nv) PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 84 clinicians in 5 Medicare specialties reassign their Medicare billing to Centerwell Senior Primary Care (nv) PC. 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. The largest specialties are Family Practice (31), Nurse Practitioner (26) and Internal Medicine (15). Of these, 3 practice at this address and 46 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.