Individual provider Active NPI

Kristopher Kevin Kleinman, R.N, N.P

  • Gerontology Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1083076269
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
810017 Issued in NV
Practice address
5550 Painted Mirage Rd Ste 217
Las Vegas, NV 89149
Phone
(702) 410-9800
NPI assigned
Mar 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN82632 NV
Gerontology Nurse Practitioner 363LG0600X 810017 NV Primary

Addresses

Primary practice location

5550 Painted Mirage Rd Ste 217
Las Vegas, NV 89149

Mailing address

11752 Via Esperanza Ave
Las Vegas, NV 89138-6025
Phone (801) 792-8012

Other practice location 1

3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Phone (702) 616-5000

Other identifiers 1

IdentifierTypeStateIssuer
810017OtherNVNEVADA NURSING BOARD

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
I20180827003600 NV Practitioner - Nurse Practitioner 1658620471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reynolds Plastic SurgeryGroup PAC ID 7810151198, 2 clinicians

Practice addresses (Care Compare)

5550 Painted Mirage Rd
Suite 217
Las Vegas, NV 89149-4620
Phone (702) 410-9800

Hospital & facility affiliations

  • Spring Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290046

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN82632NVMDRegistered Nurse
810017NVMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elkhorn Surgery Center LLC PastSince Mar 31, 2025 Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1083076269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11752 VIA ESPERANZA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891386025",
            "telephone_number": "801-792-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 PAINTED MIRAGE RD STE 217",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89149",
            "telephone_number": "702-410-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 Saint Rose Pkwy",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890523839",
            "country_code": "US",
            "telephone_number": "702-616-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEINMAN",
        "first_name": "KRISTOPHER",
        "middle_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "R.N, N.P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-25",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN82632",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NV",
            "license": "810017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA NURSING BOARD",
            "identifier": "810017",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.