Individual provider Active NPI

Mary Kristine Hispano Daria, APRN, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1386212504
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
842511 Issued in NV
Practice address
10624 S Eastern Ave Ste a-955
Henderson, NV 89052-2982
Phone
(702) 407-7700
NPI assigned
Jun 14, 2021
Last updated
Sep 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2100X 842511 NV Primary

Addresses

Primary practice location

10624 S Eastern Ave Ste a-955
Henderson, NV 89052-2982

Mailing address

11196 Burning River St
Las Vegas, NV 89183-5113
Phone (702) 918-9217

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
I20210907003110 NV Practitioner - Nurse Practitioner 0042616633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platinum Hospitalists LLPGroup PAC ID 7214076322, 197 clinicians

Practice addresses (Care Compare)

5495 S Rainbow Blvd
Suite 202
Las Vegas, NV 89118-1873
Phone (725) 205-1249

7495 W Azure Dr
Suite 209
Las Vegas, NV 89130-4440
Phone (702) 407-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
61.15 of 100Reported as group
Quality
36.67
Improvement activities
40
Cost
61.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
842511NVMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Platinum Hospitalists LLP CurrentSince Sep 1, 2021 Accepting new patients
Platinum Hospitalists LLP Single Specialty CurrentSince Sep 1, 2021 Accepting new patients

Locations

10624 S Eastern Ave
#A955
Henderson, NV 89052
Phone (702) 407-7700

10624 S Eastern Ave
Ste A955
Henderson, NV 89052
Phone (702) 407-7700

10624 S Eastern Ave
Ste A995
Henderson, NV 89052

3001 Saint Rose Pkwy
Henderson, NV 89052
Phone (702) 615-5000

7495 W Azure Dr
Ste 209
Las Vegas, NV 89130
Phone (702) 327-6653

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1386212504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11196 BURNING RIVER ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891835113",
            "telephone_number": "702-918-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE STE A-955",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-407-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARIA",
        "first_name": "MARY KRISTINE",
        "middle_name": "HISPANO",
        "credential": "APRN, AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NV",
            "license": "842511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.