MEDICARE: DR. STEPHEN VINCENT DISABATINO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	MD70061258	WA
2	207P00000X	Emergency Medicine Physician	17932	NV
3	207P00000X	Emergency Medicine Physician	C4822	KY

General Provider Information

NPI Number	:	1881089829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN VINCENT DISABATINO M.D.

Provider Business Mailing Address
First Line	:	500 N RAINBOW BLVD STE 203
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1084
Country	:	US
Telephone Number	:	702-259-1228
Fax Number	:	702-259-1252

Provider Business Practice Location Address
First Line	:	5400 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118
Country	:	US
Telephone Number	:	702-853-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2015
Last Update Date	:	01/21/2026

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