Individual provider Active NPI

Eileen Pablo Justo, APRN-CNP

  • Acute Care Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1689230500
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
818049 Issued in NV
Practice address
6276 S Rainbow Blvd
Las Vegas, NV 89118-3242
Phone
(702) 220-5557
Fax
(702) 220-5565
NPI assigned
May 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 818049 NV Primary

Addresses

Primary practice location

6276 S Rainbow Blvd
Las Vegas, NV 89118-3242

Mailing address

10239 Montes Vascos Dr
Las Vegas, NV 89178-8450
Phone (808) 375-6097

Other practice location 1

6276 S Rainbow Blvd
Las Vegas, NV 89118-3242
Phone (702) 220-5557

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
I20190808001091 NV Practitioner - Nurse Practitioner 8224365663 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Malone-Davis Neurology PLLCGroup PAC ID 4880968734, 8 clinicians

Practice addresses (Care Compare)

4510 S Eastern Ave
Suite 4
Las Vegas, NV 89119-6118
Phone (725) 221-1568

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
818049NVMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Malone-Davis Neurology PLLC CurrentSince Jul 25, 2022 Accepting new patients
Mouchir S Harb MD LTD CurrentSince Jun 15, 2019 Accepting new patients

Locations

4510 S Eastern Ave
Ste 4
Las Vegas, NV 89119
Phone (702) 796-0201

6276 S Rainbow Blvd
Ste 100
Las Vegas, NV 89118
Phone (702) 220-5557

2075 E Flamingo Rd
Las Vegas, NV 89119
Phone (702) 369-7613

7730 W Cheyenne Ave
Ste 107
Las Vegas, NV 89129
Phone (702) 240-8646

8020 S Rainbow Blvd
Ste 100
Las Vegas, NV 89139
Phone (432) 210-8950

Interoperability endpoints

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

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1689230500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10239 MONTES VASCOS DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891788450",
            "telephone_number": "808-375-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6276 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183242",
            "telephone_number": "702-220-5557",
            "fax_number": "702-220-5565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6276 S Rainbow Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891183242",
            "country_code": "US",
            "telephone_number": "702-220-5557",
            "fax_number": "702-220-5565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUSTO",
        "first_name": "EILEEN",
        "middle_name": "PABLO",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-16",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NV",
            "license": "818049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.