Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Roland Jayson Formoso Pua, MD

Individual provider Geriatric Medicine (Internal Medicine) Physician · NPI 1215009782

Dr. Roland Jayson Formoso Pua, MD is an Internal Medicine in Las Vegas, Nevada. Qualified in 1999, 27 years ago. Practices with Medical Group LLC, a 3-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Arizona, California, Idaho and Nevada and 1 more.

Years since qualifying
27
Licensed in
AZ, CA, ID, NV, OR
In the registry since
2006
Specialties on file
5
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9460 W Flamingo Rd Ste 120
Las Vegas, NV 89147-5742
Phone: (702) 638-7705
Fax: (702) 638-7706
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1144 65th St Ste F, Oakland, CA 94608-1053 — (510) 929-1400
  • 781 Mill St, Reno, NV 89502-1320 — (775) 398-1980

Specialties & licences

Geriatric Medicine (Internal Medicine) Physician (primary) Taxonomy 207RG0300X · Licence 12103 (NV)
Geriatric Medicine (Internal Medicine) Physician Taxonomy 207RG0300X · Licence 67340 (AZ)
Geriatric Medicine (Internal Medicine) Physician Taxonomy 207RG0300X · Licence MD202126 (OR)
Geriatric Medicine (Internal Medicine) Physician Taxonomy 207RG0300X · Licence C175306 (CA)
Geriatric Medicine (Internal Medicine) Physician Taxonomy 207RG0300X · Licence 15963 (ID)

Record details

NPI number1215009782
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 13, 2006
Last updated in NPPESJanuary 29, 2024
Certification dateJanuary 29, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Also practisesGERIATRIC MEDICINE
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Medical Group Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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