Individual provider Active NPI

Kasra Mahmoudi

  • Adult Companion
  • Las Vegas, NV
National Provider Identifier
1730894106
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
Practice address
5967 Rosanna St
Las Vegas, NV 89113-0267
Phone
(330) 396-9428
NPI assigned
Jan 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X Primary

Addresses

Primary practice location

5967 Rosanna St
Las Vegas, NV 89113-0267

Mailing address

5967 Rosanna St
Las Vegas, NV 89113-0267
Phone (330) 396-9428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1730894106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5967 ROSANNA ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891130267",
            "telephone_number": "330-396-9428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5967 ROSANNA ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891130267",
            "telephone_number": "330-396-9428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOUDI",
        "first_name": "KASRA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-19",
        "last_updated": "2025-09-11",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.