NPIMap

Individual provider Active NPI

Mary Katherine Holstein, MSN-AGACNP

  • Acute Care Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1164196986
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
839696 Issued in NV
Practice address
4445 S Eastern Ave Ste 1
Las Vegas, NV 89119-7851
Phone
(702) 410-5319
Fax
(702) 442-1494
NPI assigned
Aug 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1048013 TX
Acute Care Nurse Practitioner 363LA2100X 839696 NV Primary

Addresses

Primary practice location

4445 S Eastern Ave Ste 1
Las Vegas, NV 89119-7851

Mailing address

4445 S Eastern Ave Ste 1
Las Vegas, NV 89119-7851
Phone (702) 410-5319

Other identifiers 1

IdentifierTypeStateIssuer
1164196986MedicaidNV

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
I20230123001896 NV Practitioner - Nurse Practitioner 9032580444 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Babak Hooshmand MD PLLCGroup PAC ID 9830439330, 16 clinicians

Practice addresses (Care Compare)

4472 S Eastern Ave
Las Vegas, NV 89119-7825
Phone (725) 705-2739

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
69.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
839696NVMDAcute Care Nurse Practitioner
1048013TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eid Nevada Critical Care PLLC CurrentSince Jan 1, 2023 Accepting new patients
Comprehensive Infectious Disease of Nevada CurrentSince Feb 1, 2024 Accepting new patients
Babak Hooshmand MD PLLC CurrentSince Aug 25, 2024 Accepting new patients
Qureshi Al-Owir PLLC Past Accepting new patients

Locations

1801 W Olympic Blvd
Pasadena, CA 91199

1801 W Olympic Blvd
#1270
Pasadena, CA 91199

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

6040 S Fort Apache Rd
Ste 100
Las Vegas, NV 89148
Phone (702) 475-4007

653 N Town Center Dr
Ste 202
Las Vegas, NV 89144
Phone (702) 233-6694

4445 S Eastern Ave
Ste 1
Las Vegas, NV 89119
Phone (702) 410-5319

801 S Rancho Dr
Ste B2
Las Vegas, NV 89106
Phone (702) 331-4808

4472 S Eastern Ave
Las Vegas, NV 89119
Phone (702) 202-1050

4445 S Eastern Ave
#1
Las Vegas, NV 89119

Interoperability endpoints

  • Direct secure messaging: mary.holstein@485048687984644.direct.elationemr.com

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 8

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": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1164196986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 S EASTERN AVE STE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197851",
            "telephone_number": "702-410-5319",
            "fax_number": "702-442-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 S EASTERN AVE STE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197851",
            "telephone_number": "702-410-5319",
            "fax_number": "702-442-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLSTEIN",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "MSN-AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1048013",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NV",
            "license": "839696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164196986",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.