Individual provider Active NPI

Camille Agbuya

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1013661495
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
851390 Issued in NV
Practice address
2000 Wellness Way
Las Vegas, NV 89106-4113
Phone
(702) 384-5101
Fax
(702) 382-5675
NPI assigned
Feb 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN86653 NV
Family Nurse Practitioner 363LF0000X 851390 NV Primary

Addresses

Primary practice location

2000 Wellness Way
Las Vegas, NV 89106-4113

Mailing address

PO Box 81345
Las Vegas, NV 89180-1345
Phone (702) 384-5101

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
I20220721003297 NV Practitioner - Nurse Practitioner 8426439498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
66.66 of 100Reported as group
Quality
64.36
Promoting interoperability
0
Improvement activities
40
Cost
74.52

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Associates, Inc. CurrentSince May 14, 2022 Accepting new patients

Locations

870 Seven Hills Dr
Ste 102
Henderson, NV 89052
Phone (702) 384-5101

2000 Wellness Way
Las Vegas, NV 89106
Phone (702) 384-5101

6900 N Durango Dr
Las Vegas, NV 89149
Phone (702) 380-1964

7200 Cathedral Rock Dr
Ste 170
Las Vegas, NV 89128
Phone (702) 256-8500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BCIBCA

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": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1013661495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81345",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891801345",
            "telephone_number": "702-384-5101",
            "fax_number": "702-382-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 WELLNESS WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064113",
            "telephone_number": "702-384-5101",
            "fax_number": "702-382-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBUYA",
        "first_name": "CAMILLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN86653",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "851390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.