Individual provider Active NPI

Jasmin Quillosa Matutis, APRN, FNP-BC

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1497324206
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
842643 Issued in NV
Practice address
4360 Blue Diamond Rd
Las Vegas, NV 89139-7783
Phone
(702) 407-0524
NPI assigned
Jun 24, 2021
Last updated
Jun 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 842643 NV Primary

Addresses

Primary practice location

4360 Blue Diamond Rd
Las Vegas, NV 89139-7783

Mailing address

4360 Blue Diamond Rd
Las Vegas, NV 89139-7783
Phone (702) 407-0524

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
I20210702001468 NV Practitioner - Nurse Practitioner 8325449994 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medinix Medical Services Singh PLLCGroup PAC ID 3476955345, 24 clinicians

Practice addresses (Care Compare)

1321 S Rainbow Blvd
Suite 101
Las Vegas, NV 89146-9047
Phone (702) 476-2287

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
842643NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carefirst Urgent Care, LLC Family Medicine CurrentSince Jul 6, 2021 Accepting new patients
Medinix Medical Services Singh PLLC Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Saint Jude Medical Group LLC Home Doctors Nurse Practitioner CurrentSince Jul 23, 2021 Accepting new patients
Apollocare Partners of Nevada, Inc. PastSince Jan 4, 2026 Accepting new patients
Clinic 21 of Nevada Zyniewicz PLLC PastSince Sep 1, 2015 Accepting new patients
Saint Jude Associates LLC Family Medicine PastSince Jul 20, 2021 Accepting new patients
CG Medical Associates Inc Family Medicine Past Accepting new patients

Locations

871 Coronado Center Dr
Ste 200
Henderson, NV 89052
Phone (702) 830-9685

1321 S Rainbow Blvd
Ste 101
Las Vegas, NV 89146
Phone (702) 476-2287

2810 W Charleston Blvd
Ste E48
Las Vegas, NV 89102
Phone (702) 870-8994

4360 Blue Diamond Rd
Las Vegas, NV 89139
Phone (702) 407-0524

4360 Blue Diamond Rd
Ste 103
Las Vegas, NV 89139
Phone (702) 407-0524

4412 W Charleston Blvd
Ste B
Las Vegas, NV 89102
Phone (702) 382-7753

5216 Boulder Hwy
Ste 105
Las Vegas, NV 89122
Phone (513) 846-6778

8379 W Sunset Rd
Ste 210
Las Vegas, NV 89113

8880 W Sunset Rd
Ste 320
Las Vegas, NV 89148
Phone (702) 476-2287

9300 Sun City Blvd
Ste 101
Las Vegas, NV 89134
Phone (702) 341-9400

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1497324206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4360 BLUE DIAMOND RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891397783",
            "telephone_number": "702-407-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 BLUE DIAMOND RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891397783",
            "telephone_number": "702-407-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUTIS",
        "first_name": "JASMIN",
        "middle_name": "QUILLOSA",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "842643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.