Individual provider Active NPI

Michele Ramirez Wijangco, FNP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1245833151
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
835596 Issued in NV
Practice address
4750 W Oakey Blvd
Las Vegas, NV 89102-1535
Phone
(702) 877-5199
NPI assigned
Nov 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 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 835596 NV Primary

Addresses

Primary practice location

4750 W Oakey Blvd
Las Vegas, NV 89102-1535

Mailing address

3758 Las Vegas Blvd S
Las Vegas, NV 89109-4132
Phone (702) 262-9028

Other practice location 1

6140 S Fort Apache Rd Ste 110
Las Vegas, NV 89148-6737
Phone (702) 933-6400

Other practice location 2

3758 Las Vegas Blvd S
Las Vegas, NV 89109-4132
Phone (702) 262-9028

Other practice location 3

3750 Rohnerville Rd
Fortuna, CA 95540-3118
Phone (707) 599-8691

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
I20210603002406 NV Practitioner - Nurse Practitioner 7517366016 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

4750 W Oakey Blvd
Las Vegas, NV 89102-1535
Phone (702) 579-3253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
835596NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Outreach Medical Center CurrentSince Dec 9, 2023 Accepting new patients
Community Outreach Medical Center CurrentSince Dec 9, 2023 Accepting new patients
Eastern Primary Care LLC Current Accepting new patients
Diverse Mind LLC Current Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Apr 1, 2024 Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients

Locations

2080 E Flamingo Rd
Ste 302
Las Vegas, NV 89119
Phone (702) 657-3873

1090 E Desert Inn Rd
Ste 200
Las Vegas, NV 89109
Phone (702) 538-9474

4750 W Oakey Blvd
Las Vegas, NV 89102
Phone (702) 724-8877

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

6859 S Eastern Ave
Ste 103
Las Vegas, NV 89119
Phone (702) 236-2078

Interoperability endpoints

  • Direct secure messaging: mwijangco120828@westdirect.optum.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": "1605916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1245833151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3758 LAS VEGAS BLVD S",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891094132",
            "telephone_number": "702-262-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 W OAKEY BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021535",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6140 S Fort Apache Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891486737",
            "country_code": "US",
            "telephone_number": "702-933-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3758 Las Vegas Blvd S",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891094132",
            "country_code": "US",
            "telephone_number": "702-262-9028",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3750 Rohnerville Rd",
            "address_purpose": "LOCATION",
            "city": "Fortuna",
            "state": "CA",
            "postal_code": "955403118",
            "country_code": "US",
            "telephone_number": "707-599-8691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIJANGCO",
        "first_name": "MICHELE",
        "middle_name": "RAMIREZ",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-21",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "835596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.