Antonette Vergara, APRN

Primary specialty

Pain Management Registered NurseTaxonomy code 163WP0000X

License

APRN002468 Issued in NV

Practice address

1569 E Flamingo Rd
Las Vegas, NV 89119-5321

Phone

(702) 476-9999

Fax

(702) 946-1343

NPI assigned

Feb 24, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Haraway Medical Group PLLCGroup PAC ID 4587990619, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: antonette.vergara@5193.chartlogic.direct-ci.com

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.

• Haraway Medical Group PLLC

  dba Red Rock Neurology & Pain Management

  • Pain Medicine (Psychiatry & Neurology) Physician
  • North Las Vegas, NV
  • NPI 1104482595
  Medicare reassignment Care Compare group
• Coppel Medical Enterprise LLC

  dba Nevada Comprehensive PainCenter

  • Pain Medicine (Anesthesiology) Physician
  • Las Vegas, NV
  • NPI 1184957268
  Medicare reassignment NPD
• Centennial Hills Hospital Medical Center

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1487771812
  NPD (past)

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1376083394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 W CHARLESTON BLVD # 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021998",
            "telephone_number": "702-476-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1569 E FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195321",
            "telephone_number": "702-476-9999",
            "fax_number": "702-946-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGARA",
        "first_name": "ANTONETTE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-24",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN002468",
            "primary": false
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pain Management",
            "state": "NV",
            "license": "APRN002468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salvacion Vereen
• Jenya Veren, MFT INTERN
• Christina Maria Vergara Aleshire, RDN, LD
• Betsaida Vergara Elizalde
• Ada Hazel Vergara
• Emmanuel Vergara, PHARMD
• Erika Kate Palafox Vergara
• Faye Bermudo Vergara
• Gaston R Vergara, M.D.
• Jessica Isabel Vergara

• Registered Nurse in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Registered Nurse in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.