Individual provider Active NPI

Lisa Moreno, APRN

  • Adult Health Nurse Practitioner
  • North Las Vegas, NV
National Provider Identifier
1194262519
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN002443 Issued in NV
Practice address
4357 Corporate Center Dr Ste 450
North Las Vegas, NV 89030-0226
Phone
(702) 644-4673
NPI assigned
Jan 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN002443 NV Primary

Addresses

Primary practice location

4357 Corporate Center Dr Ste 450
North Las Vegas, NV 89030-0226

Mailing address

4357 Corporate Center Dr Ste 450
North Las Vegas, NV 89030-0226
Phone (702) 644-4673

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
I20170406002337 NV Practitioner - Nurse Practitioner 2668758533 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN002443NVMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Easy Health Medical Solutions PC CurrentSince Jan 7, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince May 1, 2022 Accepting new patients
Ejaz Kamboj, MD, Inc. CurrentSince Sep 11, 2018 Accepting new patients

Locations

10960 Wilshire Blvd
Ste 406
Los Angeles, CA 90024

701 S Carson St
Ste 200
Carson City, NV 89701
Phone (617) 586-0958

302 E Carson Ave
Fl 10
Las Vegas, NV 89101
Phone (310) 435-5537

1770 N Buffalo Dr
Ste 103
Las Vegas, NV 89128
Phone (702) 650-0009

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: lisaa.morenonp.p1@direct.afh.nextgenshare.com

Organizations & group practices 3

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": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1194262519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4357 CORPORATE CENTER DR STE 450",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890300226",
            "telephone_number": "702-644-4673",
            "fax_number": "702-902-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4357 CORPORATE CENTER DR STE 450",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890300226",
            "telephone_number": "702-644-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "LISA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NV",
            "license": "APRN002443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.