Individual provider Active NPI

Meilan L Daguman, AGPCNP

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1083089874
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN002088 Issued in NV
Practice address
4560 S Eastern Ave Ste 15
Las Vegas, NV 89119-6182
Phone
(702) 994-7267
Fax
(702) 623-5995
NPI assigned
Dec 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 002088 NV
Nurse Practitioner 363L00000X APRN002088 NV Primary

Addresses

Primary practice location

4560 S Eastern Ave Ste 15
Las Vegas, NV 89119-6182

Mailing address

7104 Carmen Blvd
Las Vegas, NV 89128-3430
Phone (702) 815-6350

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
I20160229000756 NV Practitioner - Nurse Practitioner 2961703574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meilan L Daguman Aprn PLLCGroup PAC ID 5496035180, 3 clinicians

Practice addresses (Care Compare)

4560 S Eastern Ave
Suite 15
Las Vegas, NV 89119-6182
Phone (702) 994-7267

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002088NVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meilan L Daguman Aprn PLLC Multi-Specialty CurrentSince Oct 1, 2016 Accepting new patients
Guanaroca Medical Center Inc Multi-Specialty PastSince Jul 1, 2021 Accepting new patients

Locations

4560 S Eastern Ave
Ste 15
Las Vegas, NV 89119
Phone (702) 401-0811

2842 E Lake Mead Blvd
North Las Vegas, NV 89030
Phone (702) 314-2400

Interoperability endpoints

  • Direct secure messaging: meilan.daguman.1@28155.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1449360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1083089874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7104 CARMEN BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891283430",
            "telephone_number": "702-815-6350",
            "fax_number": "702-623-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 S EASTERN AVE STE 15",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196182",
            "telephone_number": "702-994-7267",
            "fax_number": "702-623-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGUMAN",
        "first_name": "MEILAN",
        "middle_name": "L",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-06",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "002088",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN002088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.