Individual provider Active NPI

Ma. Aleli De Guzman Malonzo, APRN

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1194146811
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
001633 Issued in NV
Practice address
6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone
(702) 479-4881
Fax
(702) 966-8662
NPI assigned
Dec 23, 2013
Last updated
Oct 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 001633 NV Primary

Addresses

Primary practice location

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133

Mailing address

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone (702) 216-3346

Other practice location 1

2662 W Horizon Ridge Pkwy
Henderson, NV 89052-2844
Phone (702) 616-9600

Other practice location 2

2716 N Tenaya Way
Las Vegas, NV 89128-0424
Phone (702) 240-8934

Other practice location 3

1000 S Rainbow Blvd
Las Vegas, NV 89145-6231
Phone (702) 479-4881

Other identifiers 1

IdentifierTypeStateIssuer
1194146811MedicaidNV

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
I20140521000306 NV Practitioner - Nurse Practitioner 3870716814 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001633NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 1, 2022 Accepting new patients
Healthcare Partners Medical Group Coats LTD Current Accepting new patients
Southwest Medical Associates, Inc CurrentSince Mar 21, 2016 Accepting new patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 1, 2022 Accepting new patients
Physicians Medical Center Kaufman, LTD Past Accepting new patients

Locations

3001 Saint Rose Pkwy
Henderson, NV 89052
Phone (702) 615-5000

595 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 566-5500

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

2704 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 243-8500

2716 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 240-8934

3150 N Tenaya Way
Ste 100
Las Vegas, NV 89128
Phone (702) 233-4950

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

6355 S Buffalo Dr
Las Vegas, NV 89113
Phone (702) 233-8855

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1194146811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-479-4881",
            "fax_number": "702-966-8662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2662 W Horizon Ridge Pkwy",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890522844",
            "country_code": "US",
            "telephone_number": "702-616-9600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2716 N Tenaya Way",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280424",
            "country_code": "US",
            "telephone_number": "702-240-8934",
            "fax_number": "702-869-2436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 S Rainbow Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891456231",
            "country_code": "US",
            "telephone_number": "702-479-4881",
            "fax_number": "702-966-8662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALONZO",
        "first_name": "MA. ALELI",
        "middle_name": "DE GUZMAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-23",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "001633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194146811",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.