Individual provider Active NPI

Conrado Neri Yutuc, FNP-C

  • Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1447971486
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
859309 Issued in NV
Practice address
1687 Sonoran Bluff Ave
Henderson, NV 89014-2678
Phone
(702) 881-0909
NPI assigned
Sep 8, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 859309 NV Primary

Addresses

Primary practice location

1687 Sonoran Bluff Ave
Henderson, NV 89014-2678

Mailing address

3000 W Charleston Blvd Ste 3
Las Vegas, NV 89102-1990
Phone (702) 881-0909

Other identifiers 1

IdentifierTypeStateIssuer
1704973205OtherNVDL

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
I20230322003137 NV Practitioner - Nurse Practitioner 9133593767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Calaguas LTDGroup PAC ID 4587795091, 5 clinicians

Practice addresses (Care Compare)

3000 W Charleston Blvd
Suite 5
Las Vegas, NV 89102-1940
Phone (702) 877-9511

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Calaguas LTD CurrentSince Nov 4, 2022 Accepting new patients

Locations

3000 W Charleston Blvd
Ste 3
Las Vegas, NV 89102

3000 W Charleston Blvd
Ste 5
Las Vegas, NV 89102
Phone (702) 623-7205

3009 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 453-4042

3000 W Charleston Blvd
Ste 1
Las Vegas, NV 89102
Phone (702) 870-1114

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1447971486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 W CHARLESTON BLVD STE 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021990",
            "telephone_number": "702-881-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1687 SONORAN BLUFF AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142678",
            "telephone_number": "702-881-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUTUC",
        "first_name": "CONRADO",
        "middle_name": "NERI",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-08",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "859309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DL",
            "identifier": "1704973205",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.