Individual provider Active NPI

Vladimir Manasewitsch, RN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1245966159
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
887307 Issued in NV
Practice address
7235 S Buffalo Dr
Las Vegas, NV 89113-4040
Phone
(702) 791-9000
NPI assigned
Jul 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 94390 NV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 887307 NV Primary

Addresses

Primary practice location

7235 S Buffalo Dr
Las Vegas, NV 89113-4040

Mailing address

911 N Buffalo Dr
Las Vegas, NV 89128-0379
Phone (702) 337-4245

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
I20250611001735 NV Practitioner - Nurse Practitioner 6305356064 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
Telehealth
Offers telehealth services
Group practices
Changing Minds Psychiatry LLCGroup PAC ID 8820365729, 51 clinicians

Practice addresses (Care Compare)

911 N Buffalo Dr
Unit 206
Las Vegas, NV 89128-0381
Phone (702) 405-8088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94390NVMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Changing Minds Psychiatry LLC CurrentSince May 29, 2025 Accepting new patients
Changing Minds Psychiatry LLC Psychiatric/Mental Health PastSince May 29, 2025 Accepting new patients

Locations

2960 W Horizon Ridge Pkwy
Henderson, NV 89052
Phone (702) 677-1104

911 N Buffalo Dr
Unit 206213
Las Vegas, NV 89128

911 N Buffalo Dr
Unit 213
Las Vegas, NV 89128
Phone 7029421774 ext. 106

911 N Buffalo Dr
Unit 206
Las Vegas, NV 89128
Phone (702) 704-8685

911 N Buffalo Dr
Las Vegas, NV 89128
Phone (702) 932-3500

Organizations & group practices 2

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": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1245966159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 N BUFFALO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280379",
            "telephone_number": "702-337-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7235 S BUFFALO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891134040",
            "telephone_number": "702-791-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANASEWITSCH",
        "first_name": "VLADIMIR",
        "name_prefix": "Mr.",
        "credential": "RN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-25",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "94390",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "887307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.