Mylene B Vicuna, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

12460 Issued in NV

Practice address

6900 N Pecos Rd
North Las Vegas, NV 89086-4400

Phone

(702) 791-9000

Fax

(702) 791-9000

NPI assigned

Apr 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Mylene Abasolo Bersamina Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Inpatient Consultants of Nevada, Inc. a Medical Corporation

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1821041070

  Internal Medicine

  NPD (past)
• Linda L. Johnson MD, LTD

  • Adult Medicine Physician
  • Henderson, NV
  • NPI 1376838110
  NPD (past)
• Dr. Terry D. Johnson, P.a.

  • Family Medicine Physician
  • Moncks Corner, SC
  • NPI 1467751495
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693094400000",
    "number": "1457577827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 N PECOS RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890864400",
            "telephone_number": "702-791-9000",
            "fax_number": "702-791-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 N PECOS RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890864400",
            "telephone_number": "702-791-9000",
            "fax_number": "702-791-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICUNA",
        "first_name": "MYLENE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2023-08-27",
        "certification_date": "2023-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "125048180",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "12460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYLENE",
            "last_name": "BERSAMINA",
            "middle_name": "ABASOLO",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fatima Grace Viado, LCSW
• Lowryanne Vick, DNP, APRN, ACNP-BC
• Maria Teresa Victorio-Hernandez
• Victorious Beginnings
• Joselo Atienza Vicuna, MD
• Amanda Nicole Vieira, CADC
• Amanda Vietti, APRN
• Evelia Vigil Montoya
• Michael Joseph Vigue, D.O.
• Christian Jason Villaflor, M.D.

• Internal Medicine Physician in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.