Individual provider Active NPI

Sibimol Sabu, NP

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1497417539
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
845360 Issued in NV
Practice address
2545 S Bruce St Ste 200
Las Vegas, NV 89169-1778
Phone
(702) 732-2438
Fax
(702) 737-5043
NPI assigned
Oct 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 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 845360 NV Primary

Addresses

Primary practice location

2545 S Bruce St Ste 200
Las Vegas, NV 89169-1778

Mailing address

2545 S Bruce St Ste 200
Las Vegas, NV 89169-1778
Phone (702) 732-2438

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
I20211110001356 NV Practitioner - Nurse Practitioner 8426447681 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rd Prabhu-Lata K Shete MDS LTDGroup PAC ID 8820994791, 13 clinicians

Practice addresses (Care Compare)

5701 W Charleston Blvd
Suite 210
Las Vegas, NV 89146-1216
Phone (702) 877-9514

Merit-based Incentive Payment System (MIPS)

Final score
27.24 of 100Reported as group
Quality
10
Improvement activities
0
Cost
70.3

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rd Prabhu-Lata K Shete MDS LTD Current Accepting new patients
Rd Prabhu-Lata K Shete MDS LTD CurrentSince Jun 15, 2023 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Oct 15, 2022 Accepting new patients
Rd Prabhu-Lata K Shete MDS LTD CurrentSince Jun 15, 2023 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Oct 15, 2022 Accepting new patients
Dignity Health Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Desert Springs Hospital Past Accepting new patients

Locations

270 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 677-3720

2920 N Green Valley Pkwy
Ste 313
Henderson, NV 89014
Phone (702) 778-3527

2920 N Green Valley Pkwy
Ste 3
Henderson, NV 89014
Phone (702) 818-2444

5701 W Charleston Blvd
Ste 107
Las Vegas, NV 89146

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

401 N Buffalo Dr
Ste 200
Las Vegas, NV 89145
Phone (702) 528-9595

5701 W Charleston Blvd
Ste 100
Las Vegas, NV 89146
Phone (702) 877-9514

5701 W Charleston Blvd
Ste 105
Las Vegas, NV 89146
Phone (702) 643-0500

5701 W Charleston Blvd
Ste 210
Las Vegas, NV 89146
Phone (702) 318-9076

1905 Civic Center Dr
Ste 201
North Las Vegas, NV 89030
Phone (702) 214-9516

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1497417539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 S BRUCE ST STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891691778",
            "telephone_number": "702-732-2438",
            "fax_number": "702-737-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 S BRUCE ST STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891691778",
            "telephone_number": "702-732-2438",
            "fax_number": "702-737-5043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABU",
        "first_name": "SIBIMOL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "845360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.