Individual provider Active NPI

Christian San Pedro

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1457245995
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
862959 Issued in NV
Practice address
3247 S Maryland Pkwy
Las Vegas, NV 89109-2412
Phone
(725) 225-6522
NPI assigned
Jun 9, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 862959 NV Primary

Addresses

Primary practice location

3247 S Maryland Pkwy
Las Vegas, NV 89109-2412

Mailing address

732 S 6TH St Ste N
Las Vegas, NV 89101-6948
Phone (725) 225-6522

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
I20250924002460 NV Practitioner - Nurse Practitioner 4385149004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4045 Spencer St
Suite 116
Las Vegas, NV 89119-5245

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
862959NVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deepa Hasija MD CurrentSince Jul 18, 2025 Accepting new patients

Locations

3247 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 776-3500

4045 Spencer St
Ste 116
Las Vegas, NV 89119
Phone (702) 780-6200

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": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1457245995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 S 6TH ST STE N",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891016948",
            "telephone_number": "725-225-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3247 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092412",
            "telephone_number": "725-225-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN PEDRO",
        "first_name": "CHRISTIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "862959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.