DR. GARY MAX DESHAZO DO NPI 1568512101

NPI Information

NPI: 1568512101
Provider Name: DR. GARY MAX DESHAZO, DO
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address: 2901 N TENAYA WAY STE 100
LAS VEGAS, NV
ZIP 89128
Phone: (702) 870-8852

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NPI Details

DR. Gary Max Deshazo, DO is a family medicine in Las Vegas, NV. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Gary Max Deshazo, DO NPI is 1568512101. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2901 N TENAYA WAY STE 100
LAS VEGAS, NV
ZIP 89128-404
Phone: (702) 870-8852
Fax: (702) 870-8914

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
Sputum specimen collection (HCPCS:89220)
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month (HCPCS:99439)
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month (HCPCS:99490)
Insertion of needle into vein for collection of blood sample (HCPCS:36415)
Assessment of emotional or behavioral problems (HCPCS:96127)
Injection of drug or substance under skin or into muscle (HCPCS:96372)
New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

The enumeration date for this NPI number is 1/12/2007 and was last updated on 2/17/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2083P0901X	Preventive Medicine	Public Health & General Preventive Medicine	380	NEVADA	No
2	261QC1500X	Clinic/Center	Community Health	380	NEVADA	No
3	207Q00000X	Family Medicine		380	NEVADA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	002002672	MEDICAID	NEVADA
2	CC4619	OTHER	NEVADA	BLUE CROSS PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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