Individual provider Active NPI

Alessandra M. Henderson, APRN

  • Family Nurse Practitioner
  • North Las Vegas, NV
National Provider Identifier
1508378688
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN002694 Issued in NV
Practice address
2315 E Cheyenne Ave Ste 100
North Las Vegas, NV 89030-8442
Phone
(702) 633-4000
Fax
(702) 633-4246
NPI assigned
Oct 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN002694 NV Primary

Addresses

Primary practice location

2315 E Cheyenne Ave Ste 100
North Las Vegas, NV 89030-8442

Mailing address

6647 Pheasant Moon St
Las Vegas, NV 89148-4252
Phone (305) 778-5451

Other practice location 1

632 Broadway Ph 12
New York, NY 10012-2614
Phone (800) 731-4254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20200406000772 HI Practitioner - Nurse Practitioner 8123457553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

888 S King St
Honolulu, HI 96813-3097
Phone (808) 522-4000

Hospital & facility affiliations

  • Straub Clinic and Hospital Hospital, Honolulu, HI, CCN 120022
  • Pali Momi Medical Center Hospital, Aiea, HI, CCN 120026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN002694NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Straub Clinic & Hospital CurrentSince Apr 6, 2020 Accepting new patients
Straub Clinic & Hospital CurrentSince Apr 6, 2020 Accepting new patients
Straub Clinic & Hospital Past Accepting new patients

Locations

98-151 Pali Momi St
Ste 142
Aiea, HI 96701
Phone (808) 483-6400

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: alessandra.henderson@450368864321540.direct.elationemr.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1508378688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6647 PHEASANT MOON ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484252",
            "telephone_number": "305-778-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 E CHEYENNE AVE STE 100",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890308442",
            "telephone_number": "702-633-4000",
            "fax_number": "702-633-4246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 Broadway Ph 12",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100122614",
            "country_code": "US",
            "telephone_number": "800-731-4254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ALESSANDRA",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.