MAVIS N MATSUMOTO, MD, LLC
NPI 1902174741
Non-Pharmacy Dispensing Site in Henderson, NV
NPI Status: Active since December 08, 2011
Contact Information
2780 W HORIZON RIDGE PKWY
SUITE 30
HENDERSON, NV
ZIP 89052
Phone: (702) 992-4050
- Organization
- Non-Pharmacy Dispensing Site
- CLIA Number: 29D1010709
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 03-20-2027
About MAVIS N MATSUMOTO, MD, LLC
This page provides the complete NPI Profile along with additional information for Mavis N Matsumoto, Md, Llc, a provider established in Henderson, Nevada operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1902174741 assigned on December 2011. The practitioner's primary taxonomy code is 332900000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Dr. Mavis Matsumoto M.d. (Owner)
- NPI
- 1902174741
- Provider Name
- MAVIS N MATSUMOTO, MD, LLC
- Entity Type
- Organization
- Location Address
- 2780 W HORIZON RIDGE PKWY SUITE 30 HENDERSON, NV 89052
- Location Phone
- (702) 992-4050
- Mailing Address
- 2980 N BEVERLY GLEN CIR SUITE 301 LOS ANGELES, CA 90077
- Mailing Phone
- (310) 474-9809
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 12-08-2011
- Last Update Date
- 04-15-2013
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Non-Pharmacy Dispensing Site
- Taxonomy Code
- 332900000X
- Type
- Suppliers
- Taxonomy Description
- A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 29D1010709
- Facility Type
- Physician Office
- Certificate Effective Date
- March 21, 2025
- Certificate Expiration Date
- March 20, 2027
- Laboratory Director
- MAVIS N. MATSUMOTO MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Mavis N Matsumoto, Md, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1902174741, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
HENDERSON, NV 89052
HENDERSON, NV 89052
HENDERSON, NV 89052
HENDERSON, NV 89052
HENDERSON, NV 89052
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1902174741, enumerated as an "organization" on December 08, 2011.
The provider is located at 2780 W HORIZON RIDGE PKWY SUITE 30 HENDERSON, NV 89052 and the phone number is (702) 992-4050.
Non-Pharmacy Dispensing Site with taxonomy code 332900000X.
