Organization Active NPI

Psychgenesis Medical, PLLC

Doing business as PsycGenesis Medical, PLLC

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1265131676
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PSYCHGENESIS MEDICAL, PLLC
Doing business as
PsycGenesis Medical, PLLC
Practice address
5695 Oak St
Las Vegas, NV 89120-1936
Phone
(702) 849-3767
Fax
(702) 441-1652
NPI assigned
Feb 24, 2023
Last updated
Apr 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
Eva Maria Rivera, NP-CNPI 1437780996
Title
Owner
Phone
(702) 849-3767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

5695 Oak St
Las Vegas, NV 89120-1936

Mailing address

5695 Oak St
Las Vegas, NV 89120-1936
Phone (702) 849-3767

Other names 1

  • PsycGenesis Medical, PLLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1265131676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5695 OAK ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891201936",
            "telephone_number": "702-849-3767",
            "fax_number": "702-441-1652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5695 OAK ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891201936",
            "telephone_number": "702-849-3767",
            "fax_number": "702-441-1652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHGENESIS MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-24",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "EVA MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-849-3767",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PsycGenesis Medical, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.