Individual provider Active NPI

Carol Ann Krisan M Omandac, FNP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1033613203
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN002773 Issued in NV
Practice address
8680 W Cheyenne Ave
Las Vegas, NV 89129-7458
Phone
(702) 750-3425
NPI assigned
Mar 21, 2018
Last updated
Jun 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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 APRN002773 NV Primary

Addresses

Primary practice location

8680 W Cheyenne Ave
Las Vegas, NV 89129-7458

Mailing address

PO Box 98978
Las Vegas, NV 89193-8978
Phone (702) 216-3346

Other identifiers 2

IdentifierTypeStateIssuer
1033613203MedicaidNV
APRN002773OtherNVSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, AZ, OR, CO, UT, WA6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20180719003888 NV Practitioner - Nurse Practitioner 9335496413 Reassigns benefits to 2 organizations
I20260303003239 AZ Practitioner - Nurse Practitioner 9335496413 Reassigns benefits to 1 organization
I20260423001236 OR Practitioner - Nurse Practitioner 9335496413 Reassigns benefits to 1 organization
I20260608003765 CO Practitioner - Nurse Practitioner 9335496413 Reassigns benefits to 1 organization
I20260618002835 UT Practitioner - Nurse Practitioner 9335496413 Reassigns benefits to 1 organization
I20260627000905 WA Practitioner - Nurse Practitioner 9335496413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Villagehealth DM LLCGroup PAC ID 2769812445, 161 clinicians

Practice addresses (Care Compare)

209 W County Line Rd
Highlands Ranch, CO 80129-1901
Phone (303) 730-6164

32275 32ND Ave S
Federal Way, WA 98001-9616
Phone (720) 703-5293

490 S State St
Orem, UT 84058-6302
Phone (385) 314-3554

6902 SE Lake Rd
Suite 100
Milwaukie, OR 97267-2148
Phone (503) 774-3350

861 Coronado Ctr Dr
Suite 212
Henderson, NV 89052-3992
Phone (303) 405-2100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN002773NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Villagehealth DM LLC CurrentSince Sep 14, 2025 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Jun 1, 2022 Accepting new patients
Intermountain Medical Holdings Nevada Inc Past Accepting new patients

Locations

209 W County Line Rd
Highlands Ranch, CO 80129
Phone (303) 730-6164

861 Coronado Center Dr
Ste 212
Henderson, NV 89052
Phone (303) 405-2100

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

6902 SE Lake Rd
Ste 100
Portland, OR 97267
Phone (503) 774-3350

490 S State St
Orem, UT 84058
Phone (385) 314-3554

32275 32nd Ave S
Federal Way, WA 98001
Phone (206) 420-5325

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1033613203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98978",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891938978",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8680 W CHEYENNE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297458",
            "telephone_number": "702-750-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMANDAC",
        "first_name": "CAROL ANN KRISAN",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033613203",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "APRN002773",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.