MEDICARE: DR. JOHN J FILDES 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	2086S0127X	Trauma Surgery Physician	7717	NV
2	208600000X	Surgery Physician	7717	NV
3	2086S0102X	Surgical Critical Care Physician	7717	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
11	CD9455	OTHER	NV	MEDICARE - RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	880330858	OTHER	NV	ANTHEM BC/BS
2	880330858	OTHER	NV	SIERRA HEALTH SERVICES
3	880330858	OTHER	NV	GREAT-WEST
4	880330858	OTHER	NV	PACIFICARE
5	967532	OTHER	NV	FIRST HEALTH/CCN
6	XPY189314	OTHER	NV	MEDI-CAL
7	629917	OTHER	NV	AHCCCS
8	880330858	OTHER	NV	AFFILIATED HEALTH FUNDS
9	880330858	OTHER	NV	CIGNA
10	880330858	OTHER	NV	UNITED HEALTHCARE
12	880330858	OTHER	NV	UNIVERSAL HEALTH NETWORK
13	880330858	OTHER	NV	HORIZON/MCC
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	537373	OTHER	NV	USA/MCO HEALTH NETWORKS
17	880330858	OTHER	NV	CHOICE CARE/HUMANA

General Provider Information

NPI Number	:	1497733265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN J FILDES M.D.

Provider Business Mailing Address
First Line	:	2040 W CHARLESTON BLVD
Second Line	:	#301
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2227
Country	:	US
Telephone Number	:	702-671-2201
Fax Number	:	702-385-9399

Provider Business Practice Location Address
First Line	:	1707 W CHARLESTON BLVD
Second Line	:	SUITE 160
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2351
Country	:	US
Telephone Number	:	702-671-2201
Fax Number	:	702-385-9399

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

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	01/03/2013

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Directions to “ DR. JOHN J FILDES M.D.” Practice Location

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