Individual provider Active NPI

Brenda C Ortiz, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • North Las Vegas, NV
National Provider Identifier
1265263370
Registry record updated Aug 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
811068 Issued in NV
Practice address
4120 Porticella Ave
North Las Vegas, NV 89084-4932
Phone
(702) 268-5625
NPI assigned
Aug 10, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 811068 NV Primary

Addresses

Primary practice location

4120 Porticella Ave
North Las Vegas, NV 89084-4932

Mailing address

4120 Porticella Ave
North Las Vegas, NV 89084-4932
Phone (702) 268-5625

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
I20240917002274 NV Practitioner - Nurse Practitioner 0042751174 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
Estra Healthcare Services LLCGroup PAC ID 5698151389, 4 clinicians

Practice addresses (Care Compare)

1330 Karen Ave
Suite B
Las Vegas, NV 89169-1260
Phone (725) 502-7699

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
811068NVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Estra Healthcare Services LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

1330 Karen Ave
#B
Las Vegas, NV 89169
Phone (702) 417-4543

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": "1723248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723248000000",
    "number": "1265263370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 PORTICELLA AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890844932",
            "telephone_number": "702-268-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 PORTICELLA AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890844932",
            "telephone_number": "702-268-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "BRENDA",
        "middle_name": "C",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-10",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "811068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.