Individual provider Active NPI

Paula Kae Rudeen

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1275949661
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6513-C Issued in NV
Practice address
1448 E Charleston Blvd
Las Vegas, NV 89104-1705
Phone
(702) 382-4061
Fax
(702) 382-4071
NPI assigned
Jul 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6513-C NV Primary

Addresses

Primary practice location

1448 E Charleston Blvd
Las Vegas, NV 89104-1705

Mailing address

1448 E Charleston Blvd
Las Vegas, NV 89104-1705
Phone (702) 382-4061

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151002001020 NV Practitioner - Clinical Social Worker 1850609355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
BMSC NV LLCGroup PAC ID 0042534182, 10 clinicians

Practice addresses (Care Compare)

8630 W Nevso Dr
Las Vegas, NV 89147-0407
Phone (702) 942-8700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6513-CNVMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
BMSC NV LLC CurrentSince Jan 15, 2022 Accepting new patients
Resurrection Enterprise, LLC Mental Health Past Accepting new patients

Locations

10204 Bode St
Ste B
Plainfield, IL 60585
Phone (630) 229-6462

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": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404691200000",
    "number": "1275949661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 E CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041705",
            "telephone_number": "702-382-4061",
            "fax_number": "702-382-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 E CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041705",
            "telephone_number": "702-382-4061",
            "fax_number": "702-382-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDEEN",
        "first_name": "PAULA",
        "middle_name": "KAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "6513-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.