Individual provider Active NPI

Reisa Inosanto Thomas, NP

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1275288839
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
856373 Issued in NV
Practice address
8116 Las Vegas Blvd S
Las Vegas, NV 89123-1015
Phone
(702) 407-7063
NPI assigned
Feb 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-3396 HI
Family Nurse Practitioner 363LF0000X 856373 NV Primary

Addresses

Primary practice location

8116 Las Vegas Blvd S
Las Vegas, NV 89123-1015

Mailing address

3857 Peachgate Ave
Las Vegas, NV 89120-2633
Phone (808) 741-3734

Other practice location 1

45-480 Kaneohe Bay Dr
Kaneohe, HI 96744-2039
Phone (808) 235-5805

Other names 1

  • Reisa Flores Inosanto Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220412002656 HI Practitioner - Nurse Practitioner 7214323625 Reassigns benefits to 1 organization
I20221108002265 NV Practitioner - Nurse Practitioner 7214323625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MC Medical Group of Nevada, P.CGroup PAC ID 1557454410, 30 clinicians

Practice addresses (Care Compare)

8116 Las Vegas Blvd S
Las Vegas, NV 89123-1015
Phone (866) 389-2727

Merit-based Incentive Payment System (MIPS)

Final score
79.58 of 100Reported as group
Quality
71.81
Improvement activities
40
Cost
83.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-3396HIMDFamily Nurse Practitioner
856373NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Hawaii, L.L.C. Family CurrentSince Mar 15, 2022 Accepting new patients
MC Medical Group of Nevada, P.C Family CurrentSince Sep 29, 2022 Accepting new patients

Locations

98-1005 Moanalua Rd
Aiea, HI 96701
Phone (808) 485-4500

45-480 Kaneohe Bay Dr
Kaneohe, HI 96744
Phone (808) 235-0885

8116 Las Vegas Blvd S
Las Vegas, NV 89123
Phone (702) 407-7063

4755 W Ann Rd
North Las Vegas, NV 89031
Phone (702) 396-2857

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

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": "1644624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1275288839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3857 PEACHGATE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891202633",
            "telephone_number": "808-741-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8116 LAS VEGAS BLVD S",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891231015",
            "telephone_number": "702-407-7063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45-480 Kaneohe Bay Dr",
            "address_purpose": "LOCATION",
            "city": "Kaneohe",
            "state": "HI",
            "postal_code": "967442039",
            "country_code": "US",
            "telephone_number": "808-235-5805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "REISA",
        "middle_name": "INOSANTO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-12",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-3396",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "856373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REISA",
            "last_name": "INOSANTO",
            "middle_name": "FLORES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.