Individual provider Active NPI

Jonathan Arcay, NP

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1780028811
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN001552 Issued in NV
Practice address
620 Shadow LN
Las Vegas, NV 89106-4119
Phone
(702) 388-4506
Fax
(702) 388-4810
NPI assigned
Apr 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN53059 NV
Family Nurse Practitioner 363LF0000X APRN001552 NV Primary

Addresses

Primary practice location

620 Shadow LN
Las Vegas, NV 89106-4119

Mailing address

PO Box 13917
Las Vegas, NV 89112-1917
Phone (800) 355-0808

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
I20130806000810 NV Practitioner - Nurse Practitioner 8527200492 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN53059NVMDRegistered Nurse
APRN001552NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shadow Emergency Physicians PLLC CurrentSince Jun 18, 2013 Accepting new patients
Shadow Emergency Physicians PLLC CurrentSince Jun 18, 2013 Accepting new patients

Locations

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

2075 E Flamingo Rd
Las Vegas, NV 89119
Phone (702) 369-7613

Organizations & group practices 3

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": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1780028811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13917",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891121917",
            "telephone_number": "800-355-0808",
            "fax_number": "310-834-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064119",
            "telephone_number": "702-388-4506",
            "fax_number": "702-388-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCAY",
        "first_name": "JONATHAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-19",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN53059",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN001552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.