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
-
Pius E. Ehiane, APRN, FNP, PMHNP-BC
-
Uzoma C Osuchukwu, M.D
-
Harvey Allan Del Rosario, PMHNP-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 29D2342495 | Advanced Psychiatry Medical Institute | Certificate of waiver | Apr 20, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063760411 | Medicaid | NV |
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- Affiliated Physical Therapy
- Bernard Agapito
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All providers in North Las Vegas, NV · Psychiatry Physician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.