Individual provider Active NPI

Ma Cecilia Jingco Gatan, APN

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1659714186
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN001502 Issued in NV
Practice address
2545 S Bruce St Ste 200
Las Vegas, NV 89169-1778
Phone
(702) 732-2438
Fax
(702) 737-5043
NPI assigned
Apr 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN001502 NV
Nurse Practitioner 363L00000X APRN001502 NV Primary

Addresses

Primary practice location

2545 S Bruce St Ste 200
Las Vegas, NV 89169-1778

Mailing address

2545 S Bruce St Ste 200
Las Vegas, NV 89169-1778
Phone (702) 732-2438

Other identifiers 1

IdentifierTypeStateIssuer
1659714186MedicaidNV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgatan35764@direct.acumenmd.com

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
I20130605000237 NV Practitioner - Nurse Practitioner 4688812571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nkdhc Rudnitsky PLLCGroup PAC ID 1557582210, 44 clinicians

Practice addresses (Care Compare)

2545 S Bruce St
Suite 200
Las Vegas, NV 89169-1731
Phone (702) 732-2438

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN001502NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Primary Care Center LLC PastSince Nov 28, 2021 Accepting new patients

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": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1659714186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 S BRUCE ST STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891691778",
            "telephone_number": "702-732-2438",
            "fax_number": "702-737-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 S BRUCE ST STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891691778",
            "telephone_number": "702-732-2438",
            "fax_number": "702-737-5043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATAN",
        "first_name": "MA CECILIA",
        "middle_name": "JINGCO",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN001502",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN001502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659714186",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgatan35764@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "2545 S Bruce St Ste 200",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891691778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.