Individual provider Active NPI

Kristina Bordinhao, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1356050355
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1196409 Issued in NV
Practice address
7710 Coral Cactus CT
Las Vegas, NV 89139-0157
Phone
(702) 812-0580
NPI assigned
Nov 17, 2022
Last updated
Nov 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1196409 NV Primary

Addresses

Primary practice location

7710 Coral Cactus CT
Las Vegas, NV 89139-0157

Mailing address

7710 Coral Cactus CT
Las Vegas, NV 89139-0157
Phone (702) 812-0580

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
I20230519001068 NV Practitioner - Physician Assistant 7012373947 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Irv Edwards MD PCGroup PAC ID 2365926698, 33 clinicians

Practice addresses (Care Compare)

1050 W Galleria Dr
Henderson, NV 89011-4800
Phone (702) 963-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1196409NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shadow Emergency Physicians PLLC Physician Assistant CurrentSince Feb 1, 2023 Accepting new patients

Locations

1050 W Galleria Dr
Henderson, NV 89011
Phone (702) 963-7000

2581 Saint Rose Pkwy
Henderson, NV 89074
Phone (702) 780-2700

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1356050355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 CORAL CACTUS CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891390157",
            "telephone_number": "702-812-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 CORAL CACTUS CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891390157",
            "telephone_number": "702-812-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDINHAO",
        "first_name": "KRISTINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "1196409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.