Individual provider Active NPI

Amanda Brasileiro de Moraes

  • Family Nurse Practitioner
  • North Las Vegas, NV
National Provider Identifier
1700747847
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN849321 Issued in NV
Practice address
4040 N MLK Blvd
North Las Vegas, NV 89032-3205
Phone
(702) 644-4673
Fax
(702) 902-5443
NPI assigned
Nov 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN849321 NV Primary

Addresses

Primary practice location

4040 N MLK Blvd
North Las Vegas, NV 89032-3205

Mailing address

4040 N MLK Blvd
North Las Vegas, NV 89032-3205
Phone (725) 400-3136

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
I20260324003973 NV Practitioner - Nurse Practitioner 1658855929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4040 N Martin Luther King Blvd a
North Las Vegas, NV 89032

725 W Town and Country Rd
Orange, CA 92868-4703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN849321NVMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: amanda.brasileiro.de.moraes.1@24264.direct.athenahealth.com

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": "1763510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1700747847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 N MLK BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890323205",
            "telephone_number": "725-400-3136",
            "fax_number": "702-902-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 N MLK BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890323205",
            "telephone_number": "702-644-4673",
            "fax_number": "702-902-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASILEIRO DE MORAES",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-19",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN849321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.