Krizelle Quiambao Mallanta

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

881287 Issued in NV

Practice address

808 Pittston Ave
Las Vegas, NV 89123-6725

Phone

(702) 773-2017

NPI assigned

Aug 6, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Western State Behavioral Health and Psychiatric Services, Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1598379117
  Medicare reassignment NPD
• Western State Pain Institute

  • Pain Clinic/Center
  • Las Vegas, NV
  • NPI 1932693447
  Medicare reassignment NPD

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1720818438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 PITTSTON AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891236725",
            "telephone_number": "702-773-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 PITTSTON AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891236725",
            "telephone_number": "702-773-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLANTA",
        "first_name": "KRIZELLE",
        "middle_name": "QUIAMBAO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "881287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gideon Malka
• Artur Malkhasyan
• Hasmik Malkhasyan, MEDICAL ASSISTANT
• Johncarlo Malkusz
• Michael Scott Mall, MD
• Maria Cristina Mallari
• Noelle D Mallari, RPH
• Lakshmi Harini Mallavarapu, DDS
• Marjorie Ann Malleck, M.D.
• Aishwarya Bharathi Mallela

• Family Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.