Organization Active NPI

Vitalis Medical Group, LLC

  • Family Medicine Physician
  • Henderson, NV
National Provider Identifier
1659165405
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VITALIS MEDICAL GROUP, LLC
Practice address
2193 Eaglecloud Dr
Henderson, NV 89074-1801
Phone
(702) 418-9965
NPI assigned
Apr 7, 2025
Last updated
Apr 28, 2025By the provider in NPPES
Organization subpart
No

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

Authorized official

Name
Yameri Monasterios Amparan
Title
Manager
Phone
(702) 418-9965

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

2193 Eaglecloud Dr
Henderson, NV 89074-1801

Mailing address

2193 Eaglecloud Dr
Henderson, NV 89074-1801
Phone (702) 418-9965

National Provider Directory

National Provider Directory

Locations

3909 S Maryland Pkwy
Ste 214
Las Vegas, NV 89119
Phone (702) 369-1090

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1659165405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2193 EAGLECLOUD DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890741801",
            "telephone_number": "702-418-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2193 EAGLECLOUD DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890741801",
            "telephone_number": "702-418-9965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALIS MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "MONASTERIOS AMPARAN",
        "authorized_official_first_name": "YAMERI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-418-9965"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.