Individual provider Active NPI

Jessie DO, APRN

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1487439923
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
870889 Issued in NV
Practice address
4445 S Eastern Ave Ste 1
Las Vegas, NV 89119-7851
Phone
(702) 410-5319
NPI assigned
Aug 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 870889 NV Primary

Addresses

Primary practice location

4445 S Eastern Ave Ste 1
Las Vegas, NV 89119-7851

Mailing address

6061 Alameda Padre Ave
Las Vegas, NV 89139-5514

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
I20231208002435 NV Practitioner - Nurse Practitioner 8527417013 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
Group practices
Eid Nevada Critical Care PLLCGroup PAC ID 9537357793, 62 clinicians

Practice addresses (Care Compare)

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 731-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eid Nevada Critical Care PLLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

1801 W Olympic Blvd
#1270
Pasadena, CA 91199

4445 S Eastern Ave
Ste 1
Las Vegas, NV 89119
Phone (702) 410-5319

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

6040 S Fort Apache Rd
Ste 100
Las Vegas, NV 89148
Phone (702) 475-4007

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.

Hospital & facility affiliations 1

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": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1487439923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6061 ALAMEDA PADRE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891395514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 S EASTERN AVE STE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197851",
            "telephone_number": "702-410-5319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "JESSIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "870889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.