Mario Oliver Tablante Godoy, APRN NP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

APRN001258 Issued in NV

Practice address

1706 W Bonanza Rd
Las Vegas, NV 89106-4704

Phone

(702) 631-6860

Fax

(702) 631-6864

NPI assigned

Apr 6, 2011

Last updated

Feb 10, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Doyne Medical Clinic IncGroup PAC ID 1951380955, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Executive Care Home Health Home health agency, Las Vegas, NV, CCN 297233

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Doyne Medical Clinic Inc.

  dba Doyne Medical Clinic

  • Primary Care Nurse Practitioner
  • Las Vegas, NV
  • NPI 1710997291

  Family

  Medicare reassignment Care Compare group NPD Authorized official
• Jam Healthcare Inc

  dba Jabez Medical Group

  • Family Medicine Physician
  • Reno, NV
  • NPI 1942894993
  Medicare reassignment NPD
• VMD Primary Providers Nevada Asplin PC

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1285210757

  Nurse Practitioner

  Medicare reassignment NPD
• DMC Medical Clinic LTD

  • Primary Care Nurse Practitioner
  • Las Vegas, NV
  • NPI 1699374256
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Melo Health Systems LLC

  dba Executive Care Home Health

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1124577127
  Care Compare affiliation

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1275822611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 BRADLEY RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891312016",
            "telephone_number": "702-239-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 W BONANZA RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064704",
            "telephone_number": "702-631-6860",
            "fax_number": "702-631-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODOY",
        "first_name": "MARIO OLIVER",
        "middle_name": "TABLANTE",
        "name_prefix": "Mr.",
        "credential": "APRN NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN001258",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NV",
            "license": "APRN001258",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN67477",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha A Godla
• Derrick Godoy
• Dustin Rivera Godoy
• Kevin R Godoy
• Luz Godoy
• Karen Godsoe
• Angela Adelr Goduti
• Ashlee Godwin
• Christopher Godwin
• Lydia Goebel, CCC-SLP

• Primary Care Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Primary Care Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.