Active NPI
Fitzwilliam Esele Musoko, APRN
- Nurse Practitioner
- Las Vegas, NV
National Provider Identifier
1003360058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 827678
- Practice address
- 1024 W Owens Ave
Las Vegas, NV 89106-2520 - Phone
- (813) 420-5470
- NPI assigned
- Aug 8, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN9342679 | FL | |
| Family Nurse Practitioner | 363LF0000X | APRN9342679 | FL | |
| Nurse Practitioner | 363L00000X | 827678 | NV | Primary |
Addresses
Primary practice location
1024 W Owens Ave
Las Vegas, NV 89106-2520
Mailing address
464 Beardsley Cir
Henderson, NV 89052-2670
Phone (813) 420-5470
Other practice location 1
5350 Spring Hill Dr
Spring Hill, FL 34606-4562
Phone (352) 688-8116
Other practice location 2
12470 Telecom Dr Ste 300W
Temple Terrace, FL 33637-0904
Phone (813) 871-8200
Other practice location 3
12470 Telecom Dr Ste 300W
Temple Terrace, FL 33637-0904
Phone (813) 871-8200
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AJW4L | Other | FL | BCBS |
| APRN9342679 | Other | FL LICENSE | |
| 018432500 | Medicaid | FL | |
| APRN827678 | Other | NV | NV APRN LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | vegas |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN9342679 | FL | MD | Nurse Practitioner |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1003360058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "464 BEARDSLEY CIR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890522670",
"telephone_number": "813-420-5470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1024 W OWENS AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891062520",
"telephone_number": "813-420-5470"
}
],
"practiceLocations": [
{
"address_1": "5350 Spring Hill Dr",
"address_purpose": "LOCATION",
"city": "Spring Hill",
"state": "FL",
"postal_code": "346064562",
"country_code": "US",
"telephone_number": "352-688-8116",
"fax_number": "352-686-9477",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12470 Telecom Dr Ste 300W",
"address_purpose": "LOCATION",
"city": "Temple Terrace",
"state": "FL",
"postal_code": "336370904",
"country_code": "US",
"telephone_number": "813-871-8200",
"fax_number": "813-357-5501",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12470 Telecom Dr Ste 300W",
"address_purpose": "LOCATION",
"city": "Temple Terrace",
"state": "FL",
"postal_code": "336370904",
"country_code": "US",
"telephone_number": "813-871-8200",
"fax_number": "813-357-5501",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MUSOKO",
"first_name": "FITZWILLIAM",
"middle_name": "ESELE",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-08",
"last_updated": "2023-03-07",
"certification_date": "2020-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "APRN9342679",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN9342679",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NV",
"license": "827678",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "AJW4L",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FL LICENSE",
"identifier": "APRN9342679",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "018432500",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NV APRN LICENSE",
"identifier": "APRN827678",
"state": "NV"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "vegas",
"affiliation": "N",
"address_1": "1024 W Owens Ave",
"city": "Las Vegas",
"state": "NV",
"country_code": "US",
"postal_code": "891062520",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.