MEDICARE: DR. ALI ALAIN MADANI MD, PHD

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	207RH0003X	Hematology & Oncology Physician	4301070143	MI
2	207RH0003X	Hematology & Oncology Physician	27176	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	860938204	OTHER	AZ	TAX ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	27176	OTHER	NV	STATE LICENSE

General Provider Information

NPI Number	:	1952374464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALI ALAIN MADANI MD, PHD

Provider Business Mailing Address
First Line	:	6355 S BUFFALO DR FL 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2133
Country	:	US
Telephone Number	:	702-216-3346
Fax Number	:

Provider Business Practice Location Address
First Line	:	2650 N TENAYA WAY STE 201
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1110
Country	:	US
Telephone Number	:	702-735-7154
Fax Number	:

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	04/07/2025

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