Individual provider Active NPI

Tatiana Sofronova Grzeda, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1609761261
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
831675 Issued in NV
Practice address
2775 S Jones Blvd Ste 101
Las Vegas, NV 89146-5632
Phone
(702) 685-3300
NPI assigned
Jun 12, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 831675 NV Primary

Addresses

Primary practice location

2775 S Jones Blvd Ste 101
Las Vegas, NV 89146-5632

Mailing address

2775 S Jones Blvd
Las Vegas, NV 89146-5631
Phone (702) 685-3300

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
I20250902004275 NV Practitioner - Nurse Practitioner 9830690536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eugene Rosenman MD LTDGroup PAC ID 9436181237, 13 clinicians

Practice addresses (Care Compare)

2775 S Jones Blvd
Suite 101
Las Begas, NV 89146-5632
Phone (702) 685-3300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eugene Rosenman, MD LTD Single Specialty CurrentSince Aug 12, 2025 Accepting new patients
Talbert Medical Group PastSince Jun 15, 2025 Accepting new patients

Locations

2775 S Jones Blvd
Ste 101
Las Vegas, NV 89146
Phone (702) 685-3300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1609761261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465631",
            "telephone_number": "702-685-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 S JONES BLVD STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465632",
            "telephone_number": "702-685-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRZEDA",
        "first_name": "TATIANA",
        "middle_name": "SOFRONOVA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "831675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.