MEDICARE: NICHOLAS JOHN CARLEVATO MD

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	2085R0202X	Diagnostic Radiology Physician	9307	NV
2	2085R0204X	Vascular & Interventional Radiology Physician	9307	NV
3	2085R0202X	Diagnostic Radiology Physician	G75259	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	300113867	OTHER	NV	RAILROAD MEDICARE
3	AX103X	OTHER	CA	MEDICARE PTAN
4	33650	OTHER	NV	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457383812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS JOHN CARLEVATO MD

Provider Business Mailing Address
First Line	:	2102 IDAHO ST
Second Line	:
City	:	ELKO
State	:	NV
Zip	:	89801-2625
Country	:	US
Telephone Number	:	775-315-2902
Fax Number	:	775-460-2368

Provider Business Practice Location Address
First Line	:	2102 IDAHO ST
Second Line	:
City	:	ELKO
State	:	NV
Zip	:	89801
Country	:	US
Telephone Number	:	775-315-2902
Fax Number	:	775-460-2368

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	12/17/2025

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Directions to “ NICHOLAS JOHN CARLEVATO MD” Practice Location

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