MEDICARE: POKROY MEDICAL GROUP OF NEVADA, LTD.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician
2	208000000X	Pediatrics Physician
3	2080P0203X	Pediatric Critical Care Medicine Physician
4	208M00000X	Hospitalist Physician
5	363LF0000X	Family Nurse Practitioner
6	363LN0000X	Neonatal Nurse Practitioner
7	363LP0200X	Pediatric Nurse Practitioner
8	2080N0001X	Neonatal-Perinatal Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1992809412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POKROY MEDICAL GROUP OF NEVADA, LTD.

Provider Business Mailing Address
First Line	:	1301 CONCORD TER
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33323-2843
Country	:	US
Telephone Number	:	800-243-3839
Fax Number	:	844-686-2961

Provider Business Practice Location Address
First Line	:	653 N TOWN CENTER DR STE 112
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-0515
Country	:	US
Telephone Number	:	702-733-0981
Fax Number	:	27-339-7517

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. OSCAR INGARAMO
Credential	:	MD
Telephone Number	:	954-384-0175

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	03/11/2024

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Directions to “POKROY MEDICAL GROUP OF NEVADA, LTD. ” Practice Location

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