DR. MICHAEL L CICCOLO (NPI# 1225165632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225165632 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL L CICCOLO |
| Credential | M.D. |
| Practice Address |
3006 S Maryland Pkwy Suite 690 Las Vegas NV 89109-2218 |
| Mailing Address |
3006 S Maryland Pkwy Ste 690 Las Vegas NV 89109-2297 |
| Practice Telephone | 7027321290 |
| Practice Fax Number | 7022601926 |
| Mailing Telephone | 7027321290 |
| Mailing Fax Number | 7022601926 |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2017-06-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9463 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | GROUP MEDICARE # | VWCLCQ | 01 |
| NV | 100500157 | 05 | |
| NV | 20-18427 | 05 |
| Street Address |
3006 S MARYLAND PKWY SUITE 690 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89109-2218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710982079 | Ronald Kirby Reed | Psychiatry & Neurology | 3006 S Maryland Pkwy, Ste 460, Las Vegas, NV 89109-2235 | 2005-06-14 |
| 1750818373 | Infectologists of Nevada, LLC | Internal Medicine | 3006 S Maryland Pkwy, Suite 780, Las Vegas, NV 89109-2218 | 2017-05-12 |
| 1992231500 | Gary Skankey, Md, PC | Internal Medicine | 3006 S Maryland Pkwy, Suite 780, Las Vegas, NV 89109-2218 | 2017-05-03 |
| 1578099180 | Elmer G Palitang, Md, PC | Internal Medicine | 3006 S Maryland Pkwy, Suite 780, Las Vegas, NV 89109-2218 | 2017-05-03 |
| 1467993295 | Jerome F Hruska, Md, Ltd | Internal Medicine | 3006 S Maryland Pkwy, Suite 780, Las Vegas, NV 89109-2218 | 2017-03-13 |
| 1679905509 | Ebla Hospitalists Group, LLC | Internal Medicine | 3006 S Maryland Pkwy, Suite 400, Las Vegas, NV 89109-2218 | 2013-08-02 |
| 1013350222 | Ikram U Khan | Surgery | 3006 S Maryland Pkwy, Suite 465, Las Vegas, NV 89109-2218 | 2013-04-08 |
| 1790099810 | Tina W Kwan | Pediatrics | 3006 S Maryland Pkwy, Suite 690, Las Vegas, NV 89109-2218 | 2010-07-30 |
| 1366760480 | Mia R Rios | Registered Nurse | 3006 S Maryland Pkwy, Suite 690, Las Vegas, NV 89109-2218 | 2010-05-13 |
| 1104144229 | Sammie K Yamagata | Registered Nurse | 3006 S Maryland Pkwy, Suite 690, Las Vegas, NV 89109-2218 | 2010-05-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820816 | Vivian Latoza Villasfer | Technician | 2770 South Maryland Parkway, Suite 205b, Las Vegas, NV 89109 | 2020-04-21 |
| 1235758236 | Happy Life Home Health Services Inc | Chore Provider | 2770 S Maryland Pkwy Suite 205-b, Las Vegas, NV 89109 | 2020-04-10 |
| 1346890662 | Jaylin Armour | Technician | 2770 S Maryland Pkwy Suite 108b Las Vegas, Nv 89109, Las Vegas, NV 89109 | 2019-09-18 |
| 1104475003 | Jasmine Thomas | Technician | 2770 S Maryland Pkwy Suite 108 B-g Las Vegas, Nv 89109, Las Vegas, NV 89109 | 2019-09-04 |
| 1982258331 | Melanee Gregory | Technician | 2770 S Maryland Okey Suite 108b, Suite 108b, Las Vegas, NV 89109 | 2019-07-24 |
| 1851877583 | Eric Darnell Thompson Jr. | Community/Behavioral Health | 2556 Shrewood Street, Unit 21, Las Vegas, NV 89109 | 2018-07-16 |
| 1144717117 | Emerging Vision Inc | Technician/Technologist | Mirage Hotel, 3400 Las Vegas Blvd S, Mirage Hotel, Las Vegas, NV 89109 | 2018-04-16 |
| 1013404110 | Emerging Vision Inc | Technician/Technologist | Mandalay Bay Resort (lobby), 3950 Las Vegas Blvd S, Mandalay Bay Resort (lobby), Las Vegas, NV 89109 | 2018-04-16 |
| 1750881736 | Amirelys Hernandez Diaz | Technician | 2770 S. Maryland Pkwy, Ste 108b-g, Las Vegas, NV 89109 | 2018-02-16 |
| 1972036663 | Ashley Murray | Registered Nurse | 2700 S Las Vegas Blvd #1506, Las Vegas, NV 89109 | 2017-04-10 |
| Find all providers in zip 89109 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265763353 | George E Merino | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5828 Calle De Honra, Las Vegas, NV 89120-2327 | 2010-01-29 |
| 1235305939 | Juan Manuel Lehoux | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3006 S Maryland Pkwy Ste 690, Las Vegas, NV 89109 | 2008-05-02 |
| 1851579395 | Larry F Cohler Md Ltd | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3061 S Maryland Pkwy Ste 202, Las Vegas, NV 89109-6227 | 2008-02-07 |
| 1194905059 | Cardiovascular and Thoracic Surgeons of Nevada Ltd | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4160 S Pecos Rd, #10, Las Vegas, NV 89121-5025 | 2007-11-08 |
| 1609902279 | Robert G Wiencek | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 7190 S Cimarron Rd, Las Vegas, NV 89113-2171 | 2007-02-26 |
| 1598793549 | Martinmd, Mavroidismd, Dhudshiamd, & Feikesmd, Cardiovascular Surgical | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5320 South Rainbow Blvd, #282, Las Vegas, NV 89118 | 2006-06-29 |
| 1124061288 | Harbinder Singh | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5380 S Rainbow Blvd Ste 110, Las Vegas, NV 89118-1878 | 2006-06-14 |
| 1902872344 | Frederick G. Schechter | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 6855 Stone Dr, Las Vegas, NV 89110-4126 | 2006-02-26 |
| 1184602914 | Demetrios K. Mavroidis | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5320 S. Rainbow Blvd, Suite 282, Las Vegas, NV 89118-1895 | 2006-01-03 |
| 1437137262 | Nancy Anne Donahoe | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5320 S. Rainbow Blvd., Ste 282, Las Vegas, NV 89118 | 2006-01-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.