Individual provider Active NPI

Roselle Ablog Lina, APRN-CNP

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1265081848
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06191111 Issued in NV
Practice address
3430 E Flamingo Rd Ste 311
Las Vegas, NV 89121-5067
Phone
(725) 712-5792
Fax
(702) 433-8739
NPI assigned
Sep 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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 F06191111 NV Primary

Addresses

Primary practice location

3430 E Flamingo Rd Ste 311
Las Vegas, NV 89121-5067

Mailing address

6330 S Pecos Rd Ste 110
Las Vegas, NV 89120-6216
Phone (702) 433-1282

Other practice location 1

6330 S Pecos Rd Ste 110
Las Vegas, NV 89120-6216
Phone (702) 433-1282

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
I20221020001274 NV Practitioner - Nurse Practitioner 9032523139

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F06191111NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Health Systems PastSince Aug 25, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18211/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1265081848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 S PECOS RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891206216",
            "telephone_number": "702-433-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 E FLAMINGO RD STE 311",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215067",
            "telephone_number": "725-712-5792",
            "fax_number": "702-433-8739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6330 S Pecos Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891206216",
            "country_code": "US",
            "telephone_number": "702-433-1282",
            "fax_number": "702-433-1559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINA",
        "first_name": "ROSELLE",
        "middle_name": "ABLOG",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "F06191111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.