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CENTERWELL SENIOR PRIMARY CARE-TENAYA
NPI 1922751643
Internal Medicine in Las Vegas, NV

Active since February 02, 2022CLIA 29D2258624 · Waiver
2601 N TENAYA WAY, LAS VEGAS, NV 89128(702) 240-8155(702) 240-8161 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: Oct 20, 2022, Feb 2, 2022 (2 updates tracked since 2022).

About Centerwell Senior Primary Care-tenaya NPPES

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

CENTERWELL SENIOR PRIMARY CARE-TENAYA (NPI 1922751643) is a healthcare organization registered as an internal medicine in Las Vegas, Nevada and active in the NPI registry since February 2022. The organization holds a CLIA Waiver certificate valid through April 24, 2028 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1922751643
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE (NV) PC
Location Address2601 N TENAYA WAYLas Vegas, NV 89128-0427
Mailing Address4700 Millenia Blvd Ste 650Orlando, FL 32839-6013 · (407) 447-7120 · Fax (407) 770-0661
Phone(702) 240-8155
Fax(702) 240-8161
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateFebruary 2, 2022
Last NPPES UpdateFebruary 15, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 15, 2024
✔ NPI 1922751643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ 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
Also ListedClinic/CenterTaxonomy 261Q00000X
2601 N TENAYA WAY, Las Vegas, NV 89128
Open in Google Maps ↗

Other Names 1

Doing Business AsCenterwell Senior Primary Care-tenaya

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

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-tenaya 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-Tenaya, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 28 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
Shahida Khan
Nurse Practitioner
NPI 1316456247
2601 N TENAYA WAY
Las Vegas, NV 89128
(702) 233-4950
✔ PECOS✔ Accepts MedicareSame address
Jerry Arellano, MD
Cardiovascular Disease (Cardiology)
NPI 1245372366
2601 N TENAYA WAY
Las Vegas, NV 89128
(702) 240-8155
✔ PECOS✔ Accepts MedicareSame address
Heather Ballantyne, APRN, FNP-C
Nurse Practitioner
NPI 1619532876
2601 N TENAYA WAY
Las Vegas, NV 89128
(702) 240-8155
✔ PECOS✔ Accepts MedicareSame address
Randy Ip, D.O.
Cardiac Electrophysiology
NPI 1023496957
2601 N TENAYA WAY
Las Vegas, NV 89128
(702) 240-8155
✔ PECOS✔ Accepts MedicareSame address
Alan Kletzky, M.D.
Internal Medicine
NPI 1770514408
2601 N TENAYA WAY
Las Vegas, NV 89128
(702) 240-8155
✔ PECOS✔ Accepts MedicareSame address
Inna Zdorovyak, MD
Family Practice
NPI 1437375433
2601 N TENAYA WAY
Las Vegas, NV 89128
(702) 240-8155
✔ PECOS✔ Accepts MedicareSame address
Rachael Taylor, NURSE PRACTITIONER
Nurse Practitioner
NPI 1588818207
3129 N RAINBOW BLVD
Las Vegas, NV 89108
(725) 220-8457
✔ PECOS✔ Accepts Medicare0.7 mi
Rose Heng
Family Practice
NPI 1235889486
3129 N RAINBOW BLVD
Las Vegas, NV 89108
(725) 220-8457
✔ PECOS✔ Accepts Medicare0.8 mi
Mahdi Moezzi, DO
Internal Medicine
NPI 1396429353
3129 N RAINBOW BLVD
Las Vegas, NV 89108
(725) 220-8457
✔ PECOS✔ Accepts Medicare0.8 mi
Jack Yang, MD
Family Practice
NPI 1720405830
3129 N RAINBOW BLVD
Las Vegas, NV 89108
(725) 220-8457
✔ PECOS✔ Accepts Medicare0.8 mi
Douglas Budde, MD
Family Practice
NPI 1457321580
915 S RAINBOW BLVD
Las Vegas, NV 89145
(725) 220-8667
✔ PECOS✔ Accepts Medicare1.9 mi
Pauline Chao, MD
Internal Medicine
NPI 1912087305
915 S RAINBOW BLVD
Las Vegas, NV 89145
(725) 220-8667
✔ PECOS✔ Accepts Medicare1.9 mi
Greg Fihn, DO
Family Practice
NPI 1114013901
915 S RAINBOW BLVD
Las Vegas, NV 89145
(725) 220-8667
✔ PECOS✔ Accepts Medicare1.9 mi
Michelle Pelagio, FNP-C
Nurse Practitioner
NPI 1437931920
80 S MARTIN LUTHER KING BLVD STE 100
Las Vegas, NV 89106
(725) 228-4500
✔ PECOS✔ Accepts Medicare5.6 mi
Binh Tran, MD
Family Practice
NPI 1801998166
80 S MARTIN LUTHER KING BLVD STE 100
Las Vegas, NV 89106
(725) 228-4500
✔ PECOS✔ Accepts Medicare5.6 mi
Kasey Abanonu, MD
Internal Medicine
NPI 1609109644
2100 W CHARLESTON BLVD
Las Vegas, NV 89102
(702) 383-2000
✔ PECOS✔ Accepts Medicare5.6 mi
Ronnie Bordador
Nurse Practitioner
NPI 1659840270
4001 S DECATUR BLVD STE 25
Las Vegas, NV 89103
(725) 224-6967
✔ PECOS✔ Accepts Medicare6.6 mi
Rosemarie Carandang, FNP
Nurse Practitioner
NPI 1821431032
4001 S DECATUR BLVD STE 25
Las Vegas, NV 89103
(725) 224-6967
✔ PECOS✔ Accepts Medicare6.6 mi
Peter Dux, MD
Family Practice
NPI 1851338917
4001 S DECATUR BLVD STE 25
Las Vegas, NV 89103
(725) 224-6967
✔ PECOS✔ Accepts Medicare6.6 mi
Aaron Singh, DO
Internal Medicine
NPI 1235889031
1766 E CHARLESTON BLVD
Las Vegas, NV 89104
(702) 843-2440
✔ PECOS✔ Accepts Medicare7.8 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 29D2258624

Centerwell Senior Primary Care-Tenaya · Las Vegas, NV
Active · expires Apr 24, 2028
CLIA Number29D2258624
Laboratory TypePhysician Office
Certificate Effective DateApril 25, 2026
Certificate Expiration DateApril 24, 2028
Laboratory DirectorTracy J Wakefield
Laboratory Phone(702) 240-8155
Laboratory LocationCenterwell Senior Primary Care-Tenaya2601 N Tenaya Way, Las Vegas, NV 89128
CLIA data matches this NPI record on: Address Name 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 1922751643. It was assigned to this organization in the NPPES registry on February 2, 2022. The provider is doing business as Centerwell Senior Primary Care-Tenaya.

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

Centerwell Senior Primary Care (nv) PC is located at 2601 N Tenaya Way, Las Vegas, NV 89128. The listed phone number is (702) 240-8155.

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, 6 practice at this address and 28 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 29D2258624) is associated with this NPI, valid through April 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Centerwell Senior Primary Care (nv) PC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Centerwell Senior Primary Care (nv) PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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.