Individual provider Active NPI

Tracilli Beswayan, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1629812334
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
877709 Issued in NV
Practice address
3201 S Maryland Pkwy
Las Vegas, NV 89109-2441
Phone
(702) 910-6857
NPI assigned
Jun 19, 2024
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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 Practitioner 363LP0808X 877709 NV Primary

Addresses

Primary practice location

3201 S Maryland Pkwy
Las Vegas, NV 89109-2441

Mailing address

525 E Rolly St
Henderson, NV 89011-5303
Phone (702) 413-8955

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
I20240809003524 NV Practitioner - Nurse Practitioner 1456899392 Reassigns benefits to 4 organizations

Care Compare profile

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

Practice addresses (Care Compare)

880 Seven Hills Dr
Suite 200
Henderson, NV 89052-4373
Phone (702) 209-2199

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
877709NVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valetudo PLLC CurrentSince May 17, 2024 Accepting new patients
Golden Touch Behavioral Care Center Prof Corp CurrentSince Oct 1, 2025 Accepting new patients
Lindsay L Wray PSYD Comprehensive Psychological Services PLLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

880 Seven Hills Dr
Ste 200
Henderson, NV 89052
Phone (702) 209-2199

2225 E Flamingo Rd
Ste 100
Las Vegas, NV 89119
Phone (702) 493-8733

2341 Renaissance Dr
Las Vegas, NV 89119
Phone (702) 245-9640

3201 S Maryland Pkwy
Ste 101
Las Vegas, NV 89109
Phone (702) 910-6857

Organizations & group practices 4

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": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1629812334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E ROLLY ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890115303",
            "telephone_number": "702-413-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092441",
            "telephone_number": "702-910-6857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESWAYAN",
        "first_name": "TRACILLI",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "877709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.