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

Prita Tandyasraya, MD

Individual provider Neurology Physician · NPI 1144754979

Prita Tandyasraya, MD is a Neurology in Nellis AFB, Nevada. Qualified in 2017, 9 years ago. Practices with Summit Healthcare Association, a 72-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Arizona and Florida.

Years since qualifying
9
Licensed in
AZ, FL
In the registry since
2017
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone: (702) 653-3244
Fax: (702) 653-2378
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2400 S Avenue A, Yuma, AZ 85364-7127 — (928) 344-2000
  • 11215 Metro Pkwy Ste 100, Fort Myers, FL 33966-1206 — (239) 208-2212

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence R76053 (AZ)
Neurology Physician Taxonomy 2084N0400X · Licence 63541 (AZ)
Neurology Physician Taxonomy 2084N0400X · Licence ME165558 (FL)

Record details

NPI number1144754979
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 19, 2017
Last updated in NPPESMarch 16, 2026
Certification dateMarch 16, 2026
Mailing address4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600

Medicare enrollment

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

Medicare specialtyNEUROLOGY
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Summit Healthcare Association — 72 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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