Individual provider Active NPI

Mercy Melanie Bormate Vismanos, APRN

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1679341788
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
818069 Issued in NV
Practice address
3835 S Jones Blvd Ste 104
Las Vegas, NV 89103-2283
Phone
(702) 880-4193
NPI assigned
Dec 18, 2023
Last updated
Dec 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 818069 NV Primary

Addresses

Primary practice location

3835 S Jones Blvd Ste 104
Las Vegas, NV 89103-2283

Mailing address

4424 Kalamazoo St
Las Vegas, NV 89147-8513
Phone (323) 620-4774

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
I20240313001516 NV Practitioner - Nurse Practitioner 5799120275 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Las Vegas Pain Institute and Medical Center, LLC Nurse Practitioner CurrentSince Feb 28, 2024 Accepting new patients
Comprehensive Urgent Care Past Accepting new patients
Kuhl Consulting LV Past Accepting new patients

Locations

2705 W Horizon Ridge Pkwy
Ste 110
Henderson, NV 89052
Phone (702) 227-4440

1900 N Nellis Blvd
Las Vegas, NV 89115
Phone (702) 531-6440

3835 S Jones Blvd
Ste 104
Las Vegas, NV 89103
Phone 7028804193750

4616 W Sahara Ave
#337
Las Vegas, NV 89102

7175 N Durango Dr
Ste 230
Las Vegas, NV 89149
Phone (702) 410-9800

8828 Mohawk St
Las Vegas, NV 89139
Phone (832) 997-6904

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBFEDD

Organizations & group practices 3

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": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1679341788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4424 KALAMAZOO ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478513",
            "telephone_number": "323-620-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 S JONES BLVD STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891032283",
            "telephone_number": "702-880-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISMANOS",
        "first_name": "MERCY MELANIE",
        "middle_name": "BORMATE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "818069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.