Individual provider Active NPI

Aloycha Li De la Roche, APRN,BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1568469773
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN000937 Issued in NV
Practice address
6100 Iron Kettle St
Las Vegas, NV 89130-1065
Phone
(702) 308-0457
NPI assigned
Jul 1, 2005
Last updated
Nov 30, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APN000937 NV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN000937 NV Primary

Addresses

Primary practice location

6100 Iron Kettle St
Las Vegas, NV 89130-1065

Mailing address

6100 Iron Kettle St
Las Vegas, NV 89130-1065
Phone (702) 308-0457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20190606000879 OR Practitioner - Nurse Practitioner 2668497017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coos County OregonGroup PAC ID 1759353071, 6 clinicians

Practice addresses (Care Compare)

281 Laclair St
Coos Bay, OR 97420-2988
Phone (541) 266-6700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN000937NVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coos County Oregon CurrentSince Mar 12, 2019 Accepting new patients
Horizon Mental Health Management LLC Past Accepting new patients

Locations

281 Laclair St
Coos Bay, OR 97420
Phone (541) 266-6700

Organizations & group practices 2

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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1568469773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 IRON KETTLE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891301065",
            "telephone_number": "702-308-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 IRON KETTLE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891301065",
            "telephone_number": "702-308-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA ROCHE",
        "first_name": "ALOYCHA",
        "middle_name": "LI",
        "credential": "APRN,BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-01",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NV",
            "license": "APN000937",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "APN000937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.