Individual provider Active NPI

Genisha Rose Tiu Salcedo, FNP-BC

  • Family Nurse Practitioner
  • North Las Vegas, NV
National Provider Identifier
1063388841
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
887502 Issued in NV
Practice address
4040 N MLK Blvd
North Las Vegas, NV 89032-3205
Phone
(702) 353-8972
Fax
(702) 902-5443
NPI assigned
Oct 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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 887502 NV Primary

Addresses

Primary practice location

4040 N MLK Blvd
North Las Vegas, NV 89032-3205

Mailing address

4040 N MLK Blvd
North Las Vegas, NV 89032-3205
Phone (702) 353-8972

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
I20260504008236 NV Order and Referring Only - Nurse Practitioner 3678041068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
887502NVMDAdult Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1760572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1063388841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 N MLK BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890323205",
            "telephone_number": "702-353-8972",
            "fax_number": "702-902-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 N MLK BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890323205",
            "telephone_number": "702-353-8972",
            "fax_number": "702-902-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALCEDO",
        "first_name": "GENISHA ROSE",
        "middle_name": "TIU",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-16",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "887502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.