Individual provider Active NPI

Ralph Joseph Real Borromeo, APRN

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1013329515
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN001737 Issued in NV
Practice address
3835 S Jones Blvd
Las Vegas, NV 89103-7125
Phone
(702) 880-4193
Fax
(702) 880-4197
NPI assigned
Jun 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN001737 NV Primary

Addresses

Primary practice location

3835 S Jones Blvd
Las Vegas, NV 89103-7125

Mailing address

4616 W Sahara Ave
337
Las Vegas, NV 89102-3654
Phone (702) 227-4040

Other identifiers 1

IdentifierTypeStateIssuer
1013329515MedicaidNV

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
I20140828000007 NV Practitioner - Nurse Practitioner 1658599923 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Nevada LLCGroup PAC ID 7012137037, 106 clinicians

Practice addresses (Care Compare)

2202 W Craig Rd
North Las Vegas, NV 89032-3018
Phone (702) 826-3200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN001737NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, Inc CurrentSince Mar 21, 2016 Accepting new patients
Urgent Care Nevada, LLC CurrentSince May 14, 2018 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients
Comprehensive Urgent Care Past Accepting new patients

Locations

300 E Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 435-4301

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

2202 W Craig Rd
North Las Vegas, NV 89032
Phone (702) 826-3200

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 4

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": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1013329515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4616 W SAHARA AVE",
            "address_2": "337",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891023654",
            "telephone_number": "702-227-4040",
            "fax_number": "702-227-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891037125",
            "telephone_number": "702-880-4193",
            "fax_number": "702-880-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORROMEO",
        "first_name": "RALPH",
        "middle_name": "JOSEPH REAL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-02",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN001737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013329515",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.