Individual provider Active NPI

Marites Ayson Molina-Matro

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1699338756
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
819298 Issued in NV
Practice address
1294 S Jones Blvd
Las Vegas, NV 89146
Phone
(702) 877-1887
Fax
(702) 877-4536
NPI assigned
Apr 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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 819298 NV Primary

Addresses

Primary practice location

1294 S Jones Blvd
Las Vegas, NV 89146

Mailing address

1294 S Jones Blvd
Las Vegas, NV 89146
Phone (702) 877-1887

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
I20191030003084 NV Practitioner - Nurse Practitioner 1355673997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

330 S Lola LN
Suite 200
Pahrump, NV 89048-0879
Phone (702) 877-1887

8775 Deer Springs Way
Las Vegas, NV 89149-0416
Phone (702) 877-1887

9280 W Sunset Rd
Las Vegas, NV 89148-4862
Phone (702) 877-1887

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology & Endocrine Associates Inc CurrentSince Mar 4, 2020 Accepting new patients
Nephrology & Endocrine Associates Inc Nephrology CurrentSince Mar 4, 2020 Accepting new patients
Singh Medical PLLC Past Accepting new patients

Locations

100 N Green Valley Pkwy
Ste 310
Henderson, NV 89074
Phone (702) 565-6565

1294 S Jones Blvd
Las Vegas, NV 89146
Phone (702) 877-1877

9280 W Sunset Rd
Ste 438
Las Vegas, NV 89148

8775 Deer Springs Way
Las Vegas, NV 89149
Phone (702) 395-2488

500 S Rancho Dr
Ste 12
Las Vegas, NV 89106
Phone (702) 877-1877

330 S Lola Ln
Ste 200
Pahrump, NV 89048
Phone (775) 751-7100

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: marites.molina-matro@direct.davitaphysiciansolutions.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1699338756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89146",
            "telephone_number": "702-877-1887",
            "fax_number": "702-877-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89146",
            "telephone_number": "702-877-1887",
            "fax_number": "702-877-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA-MATRO",
        "first_name": "MARITES",
        "middle_name": "AYSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "819298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.