Angel LB Ambrose, MSN, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

829703 Issued in NV

Practice address

1397 S Loop Rd
Pahrump, NV 89048-4729

Phone

(775) 727-5500

Fax

(775) 727-5696

NPI assigned

Dec 22, 2015

Last updated

Oct 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Angel Boisseau, Martin, Wake Former name

Medicare fee-for-service enrollment

Enrolled in AK, NV, TX3 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 3

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Intermountain Medical Holdings Nevada IncGroup PAC ID 7416054622, 311 clinicians

Tanana Chiefs ConferenceGroup PAC ID 9537050109, 148 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Las Vegas, NV, CCN 297115
• Desert View Hospital Hospital, Pahrump, NV, CCN 291311

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angel.ambrose.1@15989.direct.athenahealth.com
• Direct secure messaging: angelambrose@hcpnv.allscriptsdirect.net
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60943

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.

• Intermountain Medical Holdings Nevada Inc

  dba Intermountain Health

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1245997279
  Medicare reassignment Care Compare group NPD
• Tanana Chiefs Conference

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1821201278

  TX

  Medicare reassignment Care Compare group NPD
• State of Alaska Department of Administration

  dba Alaska Psychiatric Institute

  • Psychiatric Hospital
  • Anchorage, AK
  • NPI 1497842553
  Medicare reassignment NPD
• Healthcare Partners Medical Group Coats LTD

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1487631917
  NPD
• Intermountain Medical Holdings Nevada Inc

  dba Intermountain Health Home Care

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1689882557
  NPD
• Tanana Chiefs Conference

  • Ambulatory Surgical Clinic/Center
  • Fairbanks, AK
  • NPI 1871332387
  NPD
• State of Alaska

  dba Alaska Psychiatric Institute Pharmacy

  • Pharmacy
  • Anchorage, AK
  • NPI 1285778191
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• DVH Hospital Alliance LLC

  dba Desert View Hospital

  • Critical Access Hospital
  • Pahrump, NV
  • NPI 1073963138
  Care Compare affiliation
• Eh Home Health of the West, LLC

  dba Enhabit Home Health

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1841680923
  Care Compare affiliation

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1073978839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "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": "1397 S LOOP RD",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890484729",
            "telephone_number": "775-727-5500",
            "fax_number": "775-727-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "ANGEL",
        "middle_name": "LB",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-22",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "829703",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "AK",
            "license": "36717",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "829703",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073978839",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "36717",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGEL",
            "last_name": "BOISSEAU, MARTIN, WAKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dawna Alley
• Alliance Mental Health Specialists Suba Park Cheng PLLC (Alliance Mental Health Specialists)
• Rupert Alovera, CNA, PTA
• Nancy D Amaya
• American Dental
• American Oncology Partners, P.a. (Hope Cancer Care of Nevada)
• Amg Medical Supplies, LLC
• Ampro Orthotics & Prosthetics Inc
• Jorge Moises Anauz, BA

• Family Nurse Practitioner in Pahrump, NV
• Providers in Pahrump, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.