Kevin Roa, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

857971 Issued in NV

Practice address

620 S Tonopah Dr
Las Vegas, NV 89106-4029

Phone

(702) 413-1391

Fax

(702) 413-1392

NPI assigned

Sep 9, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Eugene Rosenman MD LTDGroup PAC ID 9436181237, 13 clinicians

Practice addresses (Care Compare)

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.

• Eugene Rosenman, MD LTD

  • Psychiatry Physician
  • Las Vegas, NV
  • NPI 1265568703

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Luis Carlos O Ortega

  • Geriatric Psychiatry Physician
  • Las Vegas, NV
  • NPI 1760195796

  Single Specialty

  Medicare reassignment NPD
• University Medical Center of Southern Nevada

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1548393127

  Single Specialty

  Medicare reassignment NPD
• University Medical Center of Southern Nevada

  • Urgent Care Clinic/Center
  • North Las Vegas, NV
  • NPI 1104538966
  NPD
• Talbert Medical Group

  • Health Maintenance Organization
  • Costa Mesa, CA
  • NPI 1497759005
  NPD (past)

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1609597392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 S JONES BLVD STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465632",
            "telephone_number": "702-685-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S TONOPAH DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064029",
            "telephone_number": "702-413-1391",
            "fax_number": "702-413-1392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2775 S Jones Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891465632",
            "country_code": "US",
            "telephone_number": "702-685-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROA",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-09",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "857971",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "857971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760195796",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ro'Maure' Regenerative Health & Wellness
• Daniela Roa Aviles
• Roa Unlimited Inc.
• Araceli Roa
• Edgar Roa
• Ramona Roa
• Yunier Roa
• Adrienne Roach
• Matthew G Roach, D.C.
• Sanduya Roach

• Psychiatric/Mental Health Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.