Individual provider Active NPI

Kurt Ricardo, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1336719764
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
846594 Issued in NV
Practice address
6415 S Fort Apache Rd Ste 1851096
Las Vegas, NV 89148-6744
Phone
(702) 721-8131
NPI assigned
Jun 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN73820 NV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 846594 NV Primary

Addresses

Primary practice location

6415 S Fort Apache Rd Ste 1851096
Las Vegas, NV 89148-6744

Mailing address

6415 S Fort Apache Rd Ste 1851096
Las Vegas, NV 89148-6744

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
I20220106000188 NV Practitioner - Nurse Practitioner 6608267307 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Celestial Health SolutionsGroup PAC ID 8527439603, 5 clinicians
Ya Partners USAGroup PAC ID 1052853181, 8 clinicians
M R Valles Healthcare P C IncGroup PAC ID 2769572072, 3 clinicians

Practice addresses (Care Compare)

222 S Rainbow Blvd
Suite 206
Las Vegas, NV 89145-5356
Phone (702) 500-1728

7848 W Sahara Ave
Las Vegas, NV 89117-1944
Phone (702) 833-9740

9653 Mesa Ridge CT
Las Vegas, NV 89129-7818
Phone (702) 232-4210

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
846594NVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
M R Valles Healthcare P C Inc CurrentSince Dec 10, 2021 Accepting new patients
Celestial Health Solutions Psychiatric/Mental Health CurrentSince Jan 1, 2023 Accepting new patients

Locations

2255 Renaissance Dr
Ste B
Las Vegas, NV 89119
Phone (702) 500-1728

801 S Rancho Dr
Ste A2
Las Vegas, NV 89106
Phone (702) 483-3630

222 S Rainbow Blvd
Ste 206
Las Vegas, NV 89145
Phone (702) 500-1728

Organizations & group practices 3

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": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1336719764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6415 S FORT APACHE RD STE 1851096",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891486744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6415 S FORT APACHE RD STE 1851096",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891486744",
            "telephone_number": "702-721-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICARDO",
        "first_name": "KURT",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN73820",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "846594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.