Individual provider Active NPI

Jennifer Buitrago, CPNP

  • Pediatric Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1073529822
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN000838 Issued in NV
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, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141204002198 CA Practitioner - Nurse Practitioner 8426088600 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN000838NVMDNurse Practitioner
536283CAMDPediatric Nurse Practitioner
67914CAMDPediatric Nurse Practitioner
APN000838NVMDPediatric Nurse Practitioner
RN47814NVMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Los Angeles Medical Group, Inc. CurrentSince Sep 22, 2014 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.