Individual provider Active NPI

Maryana Esteban IV

  • Personal Care Attendant
  • Las Vegas, NV
National Provider Identifier
1124429964
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
NV20131150490 Issued in NV
Practice address
4348 La Jara Dr.
Las Vegas, NV 89120
Phone
(702) 689-8670
NPI assigned
Sep 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X NV20131150490 NV Primary

Addresses

Primary practice location

4348 La Jara Dr.
Las Vegas, NV 89120

Mailing address

4348 La Jara Dr
Las Vegas, NV 89120-1526
Phone (702) 689-8670

Other identifiers 1

IdentifierTypeStateIssuer
1487056909MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
NV20131150490NVMDPersonal Care Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Plus Health Care Agency LLC. Personal Care Attendant PastSince Sep 5, 2021 Accepting new patients

Organizations & group practices 1

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": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1124429964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4348 LA JARA DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891201526",
            "telephone_number": "702-689-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4348 LA JARA DR.",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89120",
            "telephone_number": "702-689-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTEBAN",
        "first_name": "MARYANA",
        "name_prefix": "Ms.",
        "name_suffix": "IV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NV",
            "license": "NV20131150490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487056909",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.