Individual provider Active NPI

Benjamin Cabasada Jr., AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1326405408
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN002146 Issued in NV
Practice address
6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone
(702) 216-3346
Fax
(702) 671-6883
NPI assigned
Jan 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN00214600 NV
Gerontology Nurse Practitioner 363LG0600X APRN002146 NV Primary
Adult Health Nurse Practitioner 363LA2200X R199626 MD

Addresses

Primary practice location

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133

Mailing address

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone (702) 216-3346

Other practice location 1

4500 W Oakey Blvd
Las Vegas, NV 89102-1527
Phone (702) 873-5110

Other identifiers 2

IdentifierTypeStateIssuer
1326405408MedicaidNV
APRN002146OtherNVSTATE LICENSE

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
I20160428000798 NV Practitioner - Nurse Practitioner 4981903739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

595 W Lake Mead Pkwy
Henderson, NV 89015-7015
Phone (702) 566-5500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN00214600NVMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 1, 2022 Accepting new patients
Healthcare Partners Medical Group Coats LTD Current Accepting new patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 1, 2022 Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. Past Accepting new patients

Locations

595 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 566-5500

4500 W Oakey Blvd
Las Vegas, NV 89102
Phone (702) 873-5110

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

Interoperability endpoints

  • Direct secure messaging: benjamincabasada@hcpnv.allscriptsdirect.net

Organizations & group practices 4

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": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1326405408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 W Oakey Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021527",
            "country_code": "US",
            "telephone_number": "702-873-5110",
            "fax_number": "702-873-8093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CABASADA",
        "first_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NV",
            "license": "APRN00214600",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NV",
            "license": "APRN002146",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R199626",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326405408",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "APRN002146",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.