MEDICARE: PEDIATRIC COLLECTIVE LLC

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	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1629946751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIC COLLECTIVE LLC

Provider Business Mailing Address
First Line	:	6675 S TENAYA WAY STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-1932
Country	:	US
Telephone Number	:	702-814-0711
Fax Number	:	702-745-1972

Provider Business Practice Location Address
First Line	:	6675 S TENAYA WAY STE 200
Second Line	:	SUITE 200 OFFICE 18
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-1932
Country	:	US
Telephone Number	:	702-814-0711
Fax Number	:	702-745-1972

Authorized Official
Title or Position	:	OWNER
Name	:	ANDREA SINGER
Credential	:	APRN
Telephone Number	:	702-814-0711

Provider Enumeration Date	:	10/29/2025
Last Update Date	:	10/29/2025

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Directions to “PEDIATRIC COLLECTIVE LLC ” Practice Location

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