Shadi Usefi-Moridani, APN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APN000973 Issued in NV

Practice address

1905 Civic Center Dr.
No. Las Vegas, NV 89030

Phone

(702) 649-3736

Fax

(702) 312-3510

NPI assigned

Sep 11, 2006

Last updated

May 11, 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BAJIBD/Endpoint/BAJIBD

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.

• Advanced Adolescent Pediatric Gastroenterology

  • Pediatric Gastroenterology Physician
  • Las Vegas, NV
  • NPI 1649464975
  NPD (past)
• University at Buffalo Pediatric Associates Inc

  • Pediatrics Physician
  • Buffalo, NY
  • NPI 1912928599
  NPD (past)

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1104920206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 W. CHARLESTON BLVD.",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89146",
            "telephone_number": "702-877-9514",
            "fax_number": "702-312-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 CIVIC CENTER DR.",
            "city": "NO. LAS VEGAS",
            "state": "NV",
            "postal_code": "89030",
            "telephone_number": "702-649-3736",
            "fax_number": "702-312-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "USEFI-MORIDANI",
        "first_name": "SHADI",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "RN55045",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APN000973",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NV",
            "license": "APN000973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104920206",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Valley Medical Supply Inc
• Yolanda Mary Vigil, LCSW

• Pediatric Nurse Practitioner in No. Las Vegas, NV
• Providers in No. Las Vegas, NV by specialty
• Pediatric Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.