Individual provider Active NPI

Ike H Mendoza, APRN

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1609664812
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
837860 Issued in NV
Practice address
5660 W Flamingo Rd Ste B
Las Vegas, NV 89103-2312
Phone
(702) 890-8147
NPI assigned
Apr 28, 2025
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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 837860 NV Primary

Addresses

Primary practice location

5660 W Flamingo Rd Ste B
Las Vegas, NV 89103-2312

Mailing address

2210 Sawtooth Mountain Dr
Henderson, NV 89044-0108
Phone (725) 777-6566

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
I20250828000909 NV Practitioner - Nurse Practitioner 7113427998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2843 Saint Rose Pkwy
Suite 110
Henderson, NV 89052-4814
Phone (725) 777-6566

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Wound Solutions LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

2843 Saint Rose Pkwy
Ste 110
Henderson, NV 89052
Phone (702) 233-4569

Organizations & group practices 1

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": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1609664812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 SAWTOOTH MOUNTAIN DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890440108",
            "telephone_number": "725-777-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5660 W FLAMINGO RD STE B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891032312",
            "telephone_number": "702-890-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "IKE",
        "middle_name": "H",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "837860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.