Individual provider Active NPI

Mackenzie Eastman, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1245078690
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
843268 Issued in NV
Practice address
5320 S Rainbow Blvd Ste 154
Las Vegas, NV 89118-1807
Phone
(702) 853-3853
Fax
(702) 853-3854
NPI assigned
Jul 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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 843268 NV Primary

Addresses

Primary practice location

5320 S Rainbow Blvd Ste 154
Las Vegas, NV 89118-1807

Mailing address

3959 Crystal Trip CT
Las Vegas, NV 89129-8338
Phone (253) 209-0726

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
I20240906003646 NV Practitioner - Nurse Practitioner 2668912445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lubna Javed MD PLLCGroup PAC ID 0648498543, 8 clinicians

Practice addresses (Care Compare)

5320 S Rainbow Blvd
Suite 154
Las Vegas, NV 89118-1807
Phone (702) 853-3853

Hospital & facility affiliations

  • Spring Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290046
  • West Henderson Hospital Hospital, Henderson, NV, CCN 290062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lubna Javed MD PLLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

10170 W Tropicana Ave
Las Vegas, NV 89147
Phone (702) 818-5555

10170 W Tropicana Ave
Ste 156
Las Vegas, NV 89147

5320 S Rainbow Blvd
Ste 154
Las Vegas, NV 89118
Phone (702) 818-5555

Organizations & group practices 1

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 4

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": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1245078690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 CRYSTAL TRIP CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891298338",
            "telephone_number": "253-209-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 S RAINBOW BLVD STE 154",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181807",
            "telephone_number": "702-853-3853",
            "fax_number": "702-853-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "MACKENZIE",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "843268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.