NPIMap

Organization Active NPI

Abide Health Medical a Professional Corp.

  • Psychiatry Physician
  • Las Vegas, NV
National Provider Identifier
1447034871
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ABIDE HEALTH MEDICAL A PROFESSIONAL CORP.
Practice address
6847 West Charleston Blvd. Suite-B
Las Vegas, NV 89117
Phone
(725) 205-1578
Fax
(725) 485-3749
NPI assigned
Aug 24, 2023
Last updated
Jun 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Authorized official

Name
Mr. Fidel Cruz
Title
President
Phone
(725) 205-1578

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

6847 West Charleston Blvd. Suite-B
Las Vegas, NV 89117

Mailing address

6847 West Charleston Blvd. Suite-B
Las Vegas, NV 89117
Phone (725) 205-1578

Other identifiers 1

IdentifierTypeStateIssuer
250030493MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231107002982 NV Part B Supplier - Clinic/Group Practice 3971950320 Receives reassigned benefits from 6 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

6847 W Charleston Blvd
Las Vegas, NV 89117
Phone (725) 205-1578

6847 W Charleston Blvd
Ste B
Las Vegas, NV 89117
Phone (725) 205-1578

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750809600000",
    "number": "1447034871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6847 WEST CHARLESTON BLVD. SUITE-B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89117",
            "telephone_number": "725-205-1578",
            "fax_number": "725-485-3749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6847 WEST CHARLESTON BLVD. SUITE-B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89117",
            "telephone_number": "725-205-1578",
            "fax_number": "725-485-3749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABIDE HEALTH MEDICAL A PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-24",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "FIDEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "725-205-1578",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250030493",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.