Individual provider Active NPI

Janal Hifumi Kono-Boelter, APRN

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1376013540
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
815833 Issued in NV
Practice address
1825 E Warm Springs Rd
Las Vegas, NV 89119-4547
Phone
(702) 361-4873
NPI assigned
Nov 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 815833 NV Primary

Addresses

Primary practice location

1825 E Warm Springs Rd
Las Vegas, NV 89119-4547

Mailing address

1825 E Warm Springs Rd
Las Vegas, NV 89119-4547
Phone (702) 612-4790

Other names 1

  • Janal Hifumi Demello Former name

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
I20190308002264 NV Practitioner - Nurse Practitioner 3476892449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.58 of 100Reported as group
Quality
71.81
Improvement activities
40
Cost
83.62

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Myndfull Care Management Nevada Singh PC CurrentSince May 1, 2024 Accepting new patients
Dana Forte D O LTD Family CurrentSince Mar 1, 2020 Accepting new patients

Locations

9010 W Cheyenne Ave
Las Vegas, NV 89129
Phone (702) 240-8646

4845 S Rainbow Blvd
Ste 402
Las Vegas, NV 89103
Phone (702) 362-9800

9436 W Lake Mead Blvd
Ste 5
Las Vegas, NV 89134
Phone (702) 328-7648

1980 Festival Plaza Dr
Ste 300
Las Vegas, NV 89135
Phone (702) 703-4246

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

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": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1376013540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 E WARM SPRINGS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891194547",
            "telephone_number": "702-612-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 E WARM SPRINGS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891194547",
            "telephone_number": "702-361-4873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONO-BOELTER",
        "first_name": "JANAL",
        "middle_name": "HIFUMI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "815833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANAL",
            "last_name": "DEMELLO",
            "middle_name": "HIFUMI",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.