Individual provider Active NPI

Mark Victorino Gomez, ARPN

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1669220133
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
876911 Issued in NV
Practice address
2110 E Flamingo Rd Ste 309
Las Vegas, NV 89119-5193
Phone
(725) 331-1100
NPI assigned
May 9, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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 876911 NV Primary

Addresses

Primary practice location

2110 E Flamingo Rd Ste 309
Las Vegas, NV 89119-5193

Mailing address

9013 Bonanza Peak CT
Las Vegas, NV 89178-9330
Phone (702) 471-8182

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
I20240731002543 NV Practitioner - Nurse Practitioner 1153780812 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
Telehealth
Offers telehealth services
Group practices
Enlightenment LLCGroup PAC ID 0446797112, 8 clinicians

Practice addresses (Care Compare)

2110 E Flamingo Rd
Suite 100
Las Vegas, NV 89119-5191
Phone (725) 331-1100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
876911NVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Enlightenment, LLC Psychiatric/Mental Health CurrentSince Jun 4, 2024 Accepting new patients

Locations

2110 E Flamingo Rd
Ste 100
Las Vegas, NV 89119
Phone (702) 971-3400

2110 E Flamingo Rd
Ste 309
Las Vegas, NV 89119
Phone (702) 551-0950

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1669220133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9013 BONANZA PEAK CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891789330",
            "telephone_number": "702-471-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 E FLAMINGO RD STE 309",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195193",
            "telephone_number": "725-331-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "MARK",
        "middle_name": "VICTORINO",
        "name_prefix": "Mr.",
        "credential": "ARPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-09",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "876911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.