NPIMap

Individual provider Active NPI

Kristin M Cavaricci, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1144793324
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2071 Issued in NV
Practice address
2020 Palomino LN Ste 100
Las Vegas, NV 89106-4894
Phone
(702) 759-8600
NPI assigned
Jan 9, 2019
Last updated
Dec 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2071 NV Primary

Addresses

Primary practice location

2020 Palomino LN Ste 100
Las Vegas, NV 89106-4894

Mailing address

2020 Palomino LN Ste 100
Las Vegas, NV 89106-4894
Phone (702) 759-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190322000971 NV Practitioner - Physician Assistant 9133469471 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Shelin Agrawal and Hyer PLLCGroup PAC ID 5890955959, 65 clinicians
Ellis Bandt Birkin Kollins and Wong PLLCGroup PAC ID 4486568946, 68 clinicians
Radiology Specialists LTD Marasso-MillerGroup PAC ID 0143110874, 136 clinicians

Practice addresses (Care Compare)

Las Vegas, NV 89106
Phone (702) 759-8600

Las Vegas, NV 89149
Phone (702) 759-8600

2811 W Horizon Ridge Pkwy
Henderson, NV 89052-4394
Phone (702) 759-8600

292 Broadcast Ave
Las Vegas, NV 89183-3527
Phone (904) 399-5550

3025 S Rainbow Blvd
Las Vegas, NV 89146-6582
Phone (702) 759-8600

3100 N Tenaya Way
Las Vegas, NV 89128-0436
Phone (866) 722-1655

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (866) 722-1655

5400 S Rainbow Blvd
Las Vegas, NV 89118-1859
Phone (702) 853-3000

657 N Town Ctr Dr
Las Vegas, NV 89144-6367
Phone (702) 233-7571

6675 S Cimarron Rd
Las Vegas, NV 89113-2132
Phone (702) 759-8600

700 Charbonne PL
Las Vegas, NV 89145-8622
Phone (904) 399-5550

7130 Smoke Ranch Rd
Las Vegas, NV 89128-3157
Phone (866) 722-1655

7200 Cathedral Rock Dr
Suite 230
Las Vegas, NV 89128-0440
Phone (702) 759-8600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2071NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, Inc CurrentSince Dec 1, 2020 Accepting new patients

Locations

2811 W Horizon Ridge Pkwy
Henderson, NV 89052

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

2020 Palomino Ln
Ste 100
Las Vegas, NV 89106
Phone (702) 759-8779

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

3920 S Eastern Ave
Ste 100
Las Vegas, NV 89119
Phone (702) 759-8779

4880 Wynn Rd
Ste 100
Las Vegas, NV 89103
Phone (702) 759-4600

5400 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 252-7342

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

7200 Cathedral Rock Dr
Ste 230
Las Vegas, NV 89128
Phone (702) 623-7568

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1144793324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVARICCI",
        "first_name": "KRISTIN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-09",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.