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DR. ROLAND JAYSON FORMOSO PUA MD NPI 1215009782


NPI Information

NPI: 1215009782
Provider Name: DR. ROLAND JAYSON FORMOSO PUA, MD
Classification: Internal Medicine - 207RG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

PECOS Registration: Yes

Address:
9460 W FLAMINGO RD
SUITE 120
LAS VEGAS, NV
ZIP 89147
Phone: (702) 638-7705
Get Directions

DR. Roland Jayson Formoso Pua, MD is a geriatric medicine internal medicine in Las Vegas, NV with 25 years of experience. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. DR. Roland Jayson Formoso Pua, MD NPI is 1215009782. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9460 W FLAMINGO RD
SUITE 120
LAS VEGAS, NV
ZIP 89147-742
Phone: (702) 638-7705
Fax: (702) 638-7706

The NPI 1215009782 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/13/2006 and was last updated on 1/29/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0300XInternal MedicineGeriatric Medicine67340ARIZONANo
2207RG0300XInternal MedicineGeriatric MedicineMD202126OREGONNo
3207RG0300XInternal MedicineGeriatric MedicineC175306CALIFORNIANo
4207RG0300XInternal MedicineGeriatric Medicine15963IDAHONo
5207RG0300XInternal MedicineGeriatric Medicine12103NEVADAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.