Individual provider Active NPI

Vanessa Beltran Mariasis, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1003672072
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
838267 Issued in NV
Practice address
6600 W Charleston Blvd Ste 142
Las Vegas, NV 89146-1050
Phone
(702) 440-8430
NPI assigned
Feb 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 838267 NV Primary

Addresses

Primary practice location

6600 W Charleston Blvd Ste 142
Las Vegas, NV 89146-1050

Mailing address

15105D John J Delaney Dr # 193
Charlotte, NC 28277-2741

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240617003351 NV Practitioner - Nurse Practitioner 7810430972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
George Washington University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stark Medicine McKay Khurana Jeider PLLCGroup PAC ID 1557601978, 23 clinicians

Practice addresses (Care Compare)

6600 W Charleston Blvd
Suite 142
Las Vegas, NV 89146-9001
Phone (702) 440-8430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
838267NVMDPsychiatric/Mental Health 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": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1003672072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15105D JOHN J DELANEY DR # 193",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282772741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 W CHARLESTON BLVD STE 142",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461050",
            "telephone_number": "702-440-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIASIS",
        "first_name": "VANESSA",
        "middle_name": "BELTRAN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "838267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.