Active NPI
Jennifer Buitrago, CPNP
- Pediatric Nurse Practitioner
- Las Vegas, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- APRN000838
- Practice address
- 1 Breakthrough Way
Las Vegas, NV 89135-3011 - Phone
- (702) 732-1493
- Fax
- (702) 732-1080
- NPI assigned
- Aug 1, 2006
- Last updated
- Nov 11, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN000838 | NV | |
| Pediatric Nurse Practitioner | 363LP0200X | APRN000838 | NV | Primary |
| Pediatric Nurse Practitioner | 363LP0200X | APN000838 | NV | |
| Pediatric Nurse Practitioner | 363LP0200X | 67914 | CA | |
| Pediatric Nurse Practitioner | 363LP0200X | 536283 | CA | |
| Pediatric Nurse Practitioner | 363LP0200X | 12738 | CA | |
| Pediatric Nurse Practitioner | 363LP0200X | RN47814 | NV |
Addresses
Primary practice location
1 Breakthrough Way
Las Vegas, NV 89135-3011
Mailing address
10170 W Tropicana Ave # 156-252
Las Vegas, NV 89147-8465
Phone (702) 732-1493
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN000838 | NV | MD | Nurse Practitioner |
| 536283 | CA | MD | Pediatric Nurse Practitioner |
| 67914 | CA | MD | Pediatric Nurse Practitioner |
| APN000838 | NV | MD | Pediatric Nurse Practitioner |
| RN47814 | NV | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Hospital Los Angeles Medical Group, Inc. | Current | Accepting new patients | |
| Allison Curtis Kingsley Meoz Michael & Sanchez PC | Nurse Practitioner | Past | Accepting new patients |
| Jonathan Bernstein MD LTD | Pediatrics | Past | Accepting new patients |
Locations
4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122
Interoperability endpoints
- jenniferbuitrago@cscn.allscriptsdirect.net
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Los Angeles, CA
- NPI 1265530653
-
dba Comprehensive Cancer Centers of Nevada
- Hematology & Oncology Physician
- Las Vegas, NV
- NPI 1598770471
Nurse Practitioner
-
dba Children's Specialty Center of Nevada
- Pediatric Hematology & Oncology Physician
- Las Vegas, NV
- NPI 1831282151
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636588800000",
"number": "1073529822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10170 W TROPICANA AVE # 156-252",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891478465",
"telephone_number": "702-732-1493",
"fax_number": "702-732-1080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BREAKTHROUGH WAY",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891353011",
"telephone_number": "702-732-1493",
"fax_number": "702-732-1080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUITRAGO",
"first_name": "JENNIFER",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2021-11-11",
"certification_date": "2021-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NV",
"license": "APRN000838",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NV",
"license": "APRN000838",
"primary": true
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NV",
"license": "APN000838",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CA",
"license": "67914",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CA",
"license": "536283",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CA",
"license": "12738",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NV",
"license": "RN47814",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.