Individual provider Active NPI

Amber Wieseckel

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1053122275
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
830797 Issued in NV
Practice address
3425 Cliff Shadows Pkwy Ste 250
Las Vegas, NV 89129-5112
Phone
(702) 382-1599
NPI assigned
Jan 16, 2025
Last updated
Jan 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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 830797 NV Primary

Addresses

Primary practice location

3425 Cliff Shadows Pkwy Ste 250
Las Vegas, NV 89129-5112

Mailing address

10616 Capitol Peak Ave
Las Vegas, NV 89166-5033
Phone (702) 741-0909

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
I20250606002079 NV Practitioner - Nurse Practitioner 1456861624 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
830797NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Molin PLLC CurrentSince May 13, 2025 Accepting new patients

Locations

3425 Cliff Shadows Pkwy
Ste 250
Las Vegas, NV 89129
Phone (702) 382-1599

Interoperability endpoints

  • Direct secure messaging: amber.wieseckel.1@31667.direct.athenahealth.com

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, 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": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1053122275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10616 CAPITOL PEAK AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891665033",
            "telephone_number": "702-741-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 CLIFF SHADOWS PKWY STE 250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891295112",
            "telephone_number": "702-382-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESECKEL",
        "first_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "830797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.