Active NPI
Mirabelle Kwek
- Nurse Practitioner
- North Las Vegas, NV
National Provider Identifier
1356057053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 861503
- Practice address
- 2315 E Cheyenne Ave Ste 100
North Las Vegas, NV 89030-8442 - Phone
- (702) 633-4000
- NPI assigned
- Jan 25, 2023
- Last updated
- Jan 25, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 861503 | NV | Primary |
Addresses
Primary practice location
2315 E Cheyenne Ave Ste 100
North Las Vegas, NV 89030-8442
Mailing address
299 Woodland Moss Rd
Las Vegas, NV 89148-2901
Phone (702) 534-8962
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 861503 | NV | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanjay Kandoth MD PC | Past | Accepting new patients |
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, 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": "1674604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674604800000",
"number": "1356057053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "299 WOODLAND MOSS RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891482901",
"telephone_number": "702-534-8962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2315 E CHEYENNE AVE STE 100",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890308442",
"telephone_number": "702-633-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWEK",
"first_name": "MIRABELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-25",
"last_updated": "2023-01-25",
"certification_date": "2023-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NV",
"license": "861503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.