SOUTHERN NEVADA MEDICAL & PEDIATRICS ASSOCIATES LLC SOS Verified
3301 W CHARLESTON BLVD, LAS VEGAS, NV 89102
NPI Number
1093230138
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: SOUTHERN NEVADA MEDICAL & PEDIATRICS ASSOCIATES, LLC
Entity Number: LLC4057-2001
Entity Type: Domestic Limited-Liability Company
Entity Status: Active
Formation Date: 2001-04-20
Name Match: 95%
Registered Agent
Name: CAMILO B. TABORA, JR.
Type: Non-Commercial Registered Agent
Address: 3301 WEST CHARLESTON BLVD, LAS VEGAS, NV, 89102
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Mmember | MARIA DESQUITADO-TABORA | 3301 W CHARLESTON BLVD, LAS VEGAS, NV, 89102 | Active |
| Mmember | CAMILO TABORA JR | 3301 W CHARLESTON BLVD, LAS VEGAS, NV, 89102 | Active |
Total Medicaid Payments
$372,037
-35% vs specialty average
Patients Seen
9,305
Total Claims
11,038
$ Per Patient
$40
Specialty avg: $79
Specialty Rank
#17 of 47
Clinic/Center, Primary Care providers in Nevada
Peer Average
$569,508
Average total for Clinic/Center, Primary Care
Claims per Patient
1.2
Average visits / services per person
Payments by Year
How much Medicaid paid this provider each year. Large jumps can indicate changes in practice volume or billing patterns.
| Year | Total Paid | % of Max |
|---|---|---|
| 2018 | $3,664 | |
| 2019 | $16,738 | |
| 2020 | $31,821 | |
| 2021 | $90,370 | |
| 2022 | $82,384 | |
| 2023 | $85,347 | |
| 2024 | $61,712 |
Procedure Code Breakdown
The specific medical services this provider billed Medicaid for. Each HCPCS/CPT code represents a different type of visit, test, or treatment.
| HCPCS Code | Description | Claims | Paid | % of Total | Avg per Claim |
|---|---|---|---|---|---|
| 99213 | Office visit for a simple problem (established patient) | 4,841 | $233,008 | 62.6% | $48 |
| 90460 | Giving a vaccine to a child, including talking with the family about it | 1,672 | $44,217 | 11.9% | $26 |
| 99393 | Wellness checkup — ages 5-11 | 197 | $17,222 | 4.6% | $87 |
| 99394 | Wellness checkup — ages 12-17 | 192 | $16,536 | 4.4% | $86 |
| 92552 | Hearing or speech test or therapy | 777 | $14,927 | 4.0% | $19 |
| Q3014 | Telehealth originating site facility fee | 682 | $13,775 | 3.7% | $20 |
| 99212 | Office visit for a minor problem (established patient) | 368 | $11,902 | 3.2% | $32 |
| 99392 | Wellness checkup — ages 1-4 | 97 | $7,506 | 2.0% | $77 |
| 90461 | Additional vaccine given to a child at the same visit | 129 | $2,933 | 0.8% | $23 |
| 99214 | Office visit for a moderate problem (established patient) | 91 | $2,366 | 0.6% | $26 |
| 99238 | Hospital discharge — doctor manages your release (30 minutes or less) | 38 | $1,287 | 0.3% | $34 |
| 90480 | Vaccine or immunization | 36 | $1,240 | 0.3% | $34 |
| 99460 | Newborn baby care — first exam in the hospital | 14 | $1,152 | 0.3% | $82 |
| 90682 | Vaccine or immunization | 89 | $730 | 0.2% | $8 |
| 99497 | Medical service or procedure | 44 | $675 | 0.2% | $15 |
| 90473 | Giving a vaccine by mouth or nose | 30 | $521 | 0.1% | $17 |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 32 | $450 | 0.1% | $14 |
| 0124A | Medical service or procedure | 14 | $445 | 0.1% | $32 |
| 85018 | Blood cell or clotting test | 217 | $274 | 0.1% | $1 |
| 90471 | Giving a vaccine by injection (shot) | 17 | $224 | 0.1% | $13 |
| 81002 | Urinalysis — quick dipstick test | 106 | $145 | 0.0% | $1 |
| 92551 | Hearing or speech test or therapy | 12 | $117 | 0.0% | $10 |
| 83655 | Blood chemistry test (checking specific substances in your blood) | 12 | $95 | 0.0% | $8 |
| 99173 | Other medical service | 406 | $72 | 0.0% | $0 |
| 94760 | Breathing test or lung function test | 66 | $68 | 0.0% | $1 |
| 96127 | Brief emotional or behavioral screening (like a depression or anxiety questionnaire) | 14 | $67 | 0.0% | $5 |
| 90688 | Vaccine or immunization | 325 | $30 | 0.0% | $0 |
| 90656 | Vaccine or immunization | 47 | $27 | 0.0% | $1 |
| 90686 | Vaccine or immunization | 176 | $15 | 0.0% | $0 |
| 90672 | Flu vaccine — nasal spray | 129 | $8 | 0.0% | $0 |
| 91312 | Medical service or procedure | 14 | $0 | 0.0% | $0 |
| 91308 | Medical service or procedure | 14 | $0 | 0.0% | $0 |
| 91300 | Medical service or procedure | 37 | $0 | 0.0% | $0 |
| 91307 | Medical service or procedure | 20 | $0 | 0.0% | $0 |
| G0008 | Administration of influenza virus vaccine | 19 | $0 | 0.0% | $0 |
| G0444 | Annual depression screening | 22 | $0 | 0.0% | $0 |
| 90649 | Vaccine or immunization | 12 | $0 | 0.0% | $0 |
| G0439 | Annual wellness visit — follow-up | 30 | $0 | 0.0% | $0 |
About This Data
This data comes from the HHS Medicaid Provider Spending dataset (opendata.hhs.gov). It shows payments made through Nevada Medicaid from 2018–2024. High payments do not mean a provider is doing anything wrong — some specialties naturally cost more, and busy providers see more patients. But unusually high numbers compared to peers can be worth a closer look.