Individual provider Active NPI

Wanesa Diane Yuhmo, FNP-BC

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1720627615
Registry record updated Mar 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
826505 Issued in NV
Practice address
4680 Polaris Ave Ste 200
Las Vegas, NV 89103-5600
Phone
(702) 909-5900
Fax
(702) 333-4777
NPI assigned
Dec 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2020

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 826505 NV Primary

Addresses

Primary practice location

4680 Polaris Ave Ste 200
Las Vegas, NV 89103-5600

Mailing address

4680 Polaris Ave Ste 200
Las Vegas, NV 89103-5600
Phone (702) 909-5900

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
I20200130002615 NV Practitioner - Nurse Practitioner 3870929441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mandt MSDLGroup PAC ID 5991867269, 6 clinicians

Practice addresses (Care Compare)

Las Vegas, NV 89145
Phone (702) 749-8885

Merit-based Incentive Payment System (MIPS)

Final score
99.7 of 100Reported as group
Quality
100
Improvement activities
40
Cost
68.78

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
M&T MSDL Infectious Disease CurrentSince Jan 9, 2020 Accepting new patients

Locations

1081 S Cimarron Rd
Ste B5
Las Vegas, NV 89145
Phone (702) 749-8885

6900 N Durango Dr
Las Vegas, NV 89149
Phone (702) 380-1964

1081 S Cimarron Rd
Ste B2
Las Vegas, NV 89145

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": "1577232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584748800000",
    "number": "1720627615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4680 POLARIS AVE STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891035600",
            "telephone_number": "702-909-5900",
            "fax_number": "702-333-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4680 POLARIS AVE STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891035600",
            "telephone_number": "702-909-5900",
            "fax_number": "702-333-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUHMO",
        "first_name": "WANESA",
        "middle_name": "DIANE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-25",
        "last_updated": "2020-03-21",
        "certification_date": "2020-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "826505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.