Individual provider Active NPI

Goldyn Dimasin, APRN

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1013624501
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN855621 Issued in NV
Practice address
3900 W Charleston Blvd Ste 170
Las Vegas, NV 89102-1682
Phone
(702) 362-2273
Fax
(702) 788-1886
NPI assigned
Nov 3, 2022
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN855621 NV Primary

Addresses

Primary practice location

3900 W Charleston Blvd Ste 170
Las Vegas, NV 89102-1682

Mailing address

3900 W Charleston Blvd Ste 170
Las Vegas, NV 89102-1682
Phone (702) 362-2273

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
I20221222001363 NV Practitioner - Nurse Practitioner 5496125080 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Priority Health System LLCGroup PAC ID 7719218544, 6 clinicians
Innovative Wound Management LLCGroup PAC ID 7719414317, 3 clinicians

Practice addresses (Care Compare)

2685 S Rainbow Blvd
Suite 201
Las Vegas, NV 89146-5189
Phone (702) 222-4339

8551 W Lake Mead Blvd
Suite 200
Las Vegas, NV 89128-7642
Phone (725) 300-0603

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN855621NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Raj P. Singh MD PLLC CurrentSince Dec 15, 2022 Accepting new patients
Jurani LLC CurrentSince Nov 2, 2023 Accepting new patients
Priority Health System LLC CurrentSince Jan 15, 2026 Accepting new patients
Innovative Wound Management, LLC CurrentSince Jan 16, 2026 Accepting new patients
Jingle Ching Kavinta PLLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

2831 Saint Rose Pkwy
Ste 200
Henderson, NV 89052
Phone (702) 355-9024

2625 S Rainbow Blvd
Ste C102
Las Vegas, NV 89146
Phone (702) 387-4577

3900 W Charleston Blvd
Ste 170
Las Vegas, NV 89102
Phone (702) 362-2273

633 N Decatur Blvd
Ste A
Las Vegas, NV 89107
Phone (702) 258-4900

8551 W Lake Mead Blvd
Ste 200
Las Vegas, NV 89128
Phone (702) 869-8720

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1013624501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 W CHARLESTON BLVD STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021682",
            "telephone_number": "702-362-2273",
            "fax_number": "702-788-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W CHARLESTON BLVD STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021682",
            "telephone_number": "702-362-2273",
            "fax_number": "702-788-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMASIN",
        "first_name": "GOLDYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN855621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.