Individual provider Active NPI

Kathleen Rose Agusto Tapalla, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1285586875
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
829743 Issued in NV
Practice address
3824 S Jones Blvd Ste B
Las Vegas, NV 89103-2451
Phone
(725) 205-5601
NPI assigned
Feb 13, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 829743 NV Primary

Addresses

Primary practice location

3824 S Jones Blvd Ste B
Las Vegas, NV 89103-2451

Mailing address

3824 S Jones Blvd Ste B
Las Vegas, NV 89103-2451
Phone (725) 205-5601

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
I20260602000782 NV Practitioner - Nurse Practitioner 7911478821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Nevada, Las Vegas School of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8687 W Sahara Ave
Suite 100
Las Vegas, NV 89117-5868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
829743NVMDPsychiatric/Mental Health Nurse Practitioner

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": "1770940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1285586875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 S JONES BLVD STE B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891032451",
            "telephone_number": "725-205-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3824 S JONES BLVD STE B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891032451",
            "telephone_number": "725-205-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAPALLA",
        "first_name": "KATHLEEN ROSE",
        "middle_name": "AGUSTO",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-13",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "829743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.