Individual provider Active NPI

Kristyn Cisilino, FNP-BC

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1275143711
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
830225 Issued in NV
Practice address
4835 S Durango Dr
Las Vegas, NV 89147-8171
Phone
(702) 877-5199
NPI assigned
Aug 7, 2020
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 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 830225 NV Primary

Addresses

Primary practice location

4835 S Durango Dr
Las Vegas, NV 89147-8171

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5199

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
I20201116002357 NV Practitioner - Nurse Practitioner 9739590175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
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)

4835 S Durango Dr
Las Vegas, NV 89147-8171
Phone (702) 579-3253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
830225NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine CurrentSince Apr 3, 2023 Accepting new patients
Unlv Medicine Current Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Sep 4, 2024 Accepting new patients
Unlv Medicine CurrentSince Apr 3, 2023 Accepting new patients
Jesse Mitchell M D Medical PC PastSince May 3, 2023 Accepting new patients

Locations

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

1707 W Charleston Blvd
Ste 230
Las Vegas, NV 89102
Phone (702) 671-5060

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

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

4835 S Durango Dr
Las Vegas, NV 89147
Phone (702) 876-0534

Interoperability endpoints

  • Direct secure messaging: kcisilino126401@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1275143711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 S DURANGO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478171",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISILINO",
        "first_name": "KRISTYN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "830225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.