Advanced Psychiatry Inc

Organization Active NPI Psychiatry Physician · North Las Vegas, NV

NPI 1497200299 · NPPES record last updated Apr 27, 2020

Key facts

NPI
1497200299
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatry Physician 2084P0800X
License
16137 (NV)
Legal business name
ADVANCED PSYCHIATRY INC
Practice address
4310 W Cheyenne Ave Ste 100
North Las Vegas, NV 89032-2484
Phone
(702) 763-7811
Fax
(702) 947-4920
NPI assigned
Aug 22, 2016
Organization subpart
No

Authorized official

Name
Dr. Uzoma Osuchukwu, MD
Title
Owner
Phone
(617) 515-2570

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2342495Advanced Psychiatry Medical Institute
4310 W Cheyenne Ave Ste 100, N Las Vegas, NV 89032
Certificate of waiverApr 20, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NV

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170505000980 NV Part B Supplier - Clinic/Group Practice 6800173576 Receives reassigned benefits from 3 practitioners
Practice locations: North Las Vegas, NV

National Provider Directory

Locations

4310 W Cheyenne Ave
North Las Vegas, NV 89032
Phone (702) 763-7811

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician
Group: 193400000X SINGLE SPECIALTY GROUP
2084P0800X 16137 NV Yes

Addresses

Primary practice location

4310 W Cheyenne Ave Ste 100
North Las Vegas, NV 89032-2484

Mailing address

4310 W Cheyenne Ave Ste 100
North Las Vegas, NV 89032-2484
Phone (702) 763-7811

Other identifiers

IdentifierTypeStateIssuer
1063760411MedicaidNV

Other providers in North Las Vegas, NV

All providers in North Las Vegas, NV · Psychiatry Physician in Nevada

Sources for this page

Verify at the official NPI Registry.