Individual provider Active NPI

Ana Katrina Mendoza Manalili, APRN

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1225650237
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN830505 Issued in NV
Practice address
624 S Tonopah Dr
Las Vegas, NV 89106-4029
Phone
(702) 463-9100
NPI assigned
May 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN830505 NV Primary

Addresses

Primary practice location

624 S Tonopah Dr
Las Vegas, NV 89106-4029

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380

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
I20201111002609 NV Practitioner - Nurse Practitioner 8729498266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group Rhodes P CGroup PAC ID 1052390036, 53 clinicians

Practice addresses (Care Compare)

58 N Pecos Rd
Henderson, NV 89074-7319
Phone (702) 877-0814

Merit-based Incentive Payment System (MIPS)

Final score
89.7 of 100Reported as group
Quality
82.63
Promoting interoperability
100
Improvement activities
40
Cost
83.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN830505NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Springs Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amanalili120696@westdirect.optum.com
  • Direct secure messaging: ana.manalili@cccn.ikm.direct-ci.com

Organizations & group practices 6

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": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1225650237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 S TONOPAH DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064029",
            "telephone_number": "702-463-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANALILI",
        "first_name": "ANA KATRINA",
        "middle_name": "MENDOZA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN830505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.