Jerome Agullana Nicolas, APRN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

874921 Issued in NV

Practice address

5380 S Rainbow Blvd Ste 110
Las Vegas, NV 89118-1878

Phone

(725) 333-8465

Fax

(725) 333-8466

NPI assigned

Mar 28, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Las Vegas Medical Group LLCGroup PAC ID 6800118522, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spring Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290046
• Summerlin Hospital Medical Center Hospital, Las Vegas, NV, CCN 290041
• Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290021

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Las Vegas Medical Group LLC

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1447656988
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Spring Valley Medical Center

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1346230323
  Care Compare affiliation
• Spring Valley Medical Center

  • Emergency Care Clinic/Center
  • Las Vegas, NV
  • NPI 1588219117

  Hospital

  Care Compare affiliation
• Spring Valley Medical Center

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1982289690
  Care Compare affiliation
• Summerlin Hospital Medical Center L L C

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1831189638
  Care Compare affiliation
• Summerlin Hospital Medical Center L L C

  • Emergency Care Clinic/Center
  • Las Vegas, NV
  • NPI 1861234619

  Hospital

  Care Compare affiliation
• Valley Hospital Medical Center

  • Emergency Care Clinic/Center
  • Las Vegas, NV
  • NPI 1396436630

  Hospital

  Care Compare affiliation
• Valley Hospital Medical Center

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1417947490
  Care Compare affiliation
• Valley Hospital Medical Center

  • Emergency Care Clinic/Center
  • Las Vegas, NV
  • NPI 1598479602

  Hospital

  Care Compare affiliation
• Valley Hospital Medical Center

  • Emergency Care Clinic/Center
  • Las Vegas, NV
  • NPI 1770150914

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1497506463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 S RAINBOW BLVD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181878",
            "telephone_number": "725-333-8465",
            "fax_number": "725-333-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 S RAINBOW BLVD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181878",
            "telephone_number": "725-333-8465",
            "fax_number": "725-333-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLAS",
        "first_name": "JEROME",
        "middle_name": "AGULLANA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NV",
            "license": "874921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Robert Nicola, D.C.
• Adina Maria Nicolaou
• Christopher Nicolaou, MD
• Nicolas Ponzo, LCSW, LTD
• Gladys Joss Pascua Nicolas
• Louricha Lousuca Nicolas
• Michael Gatchalian Nicolas, MSN, APRN, FNP-BC
• Rachelle Lagman Nicolas, PHARMD
• Teresita M Nicolas
• Rocenia Nicolau

• Acute Care Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Acute Care Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.