Abraham Agdamag, APRN-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

820067 Issued in NV

Practice address

1641 E Flamingo Rd Ste 7
Las Vegas, NV 89119-5257

Phone

(702) 485-4575

Fax

(702) 485-4573

NPI assigned

Apr 29, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

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.

• Behavioral Health Institute Inc (Singh) PC

  • Addiction Medicine (Family Medicine) Physician
  • Las Vegas, NV
  • NPI 1205005980

  NV, Single Specialty

  Medicare reassignment NPD
• Nevada Psych Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1598433039

  Single Specialty

  NPD
• Carelink Medical Group of Nevada LLC

  • Clinic/Center
  • Las Vegas, NV
  • NPI 1780001347

  Single Specialty

  NPD (past)
• Open Arms Counseling LLC

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1851733042

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1730743451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 TARTAN HILL AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891418602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 E FLAMINGO RD STE 7",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195257",
            "telephone_number": "702-485-4575",
            "fax_number": "702-485-4573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5409 Tartan Hill Ave",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891418602",
            "country_code": "US",
            "telephone_number": "702-334-6019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGDAMAG",
        "first_name": "ABRAHAM",
        "credential": "APRN-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-29",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "820067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730743451",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@nvpsychhealth.com",
            "affiliation": "N",
            "endpointDescription": "Main Office Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1641 E Flamingo Rd Ste 7",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891195257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Girlie S Agcaoili
• Honey Mary G Agcaoili, RN
• Joseph Agcaoili, PTA
• Josephine Rebibes Agcaoili, LMT
• Leonarda Agcaoili
• Dorothy May Desierto Agdamag, APRN
• Agdfvcounseling LLC
• Aged Living Facility
• Aged Living Facility
• Aurbrey Agee

• All providers in Las Vegas, NV
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.