NPIMap

Individual provider Active NPI

Melchor San Pedro, APRN-C

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1811529845
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
829103 Issued in NV
Practice address
2250 E Flamingo Rd
Las Vegas, NV 89119-5170
Phone
(702) 703-4340
Fax
(877) 951-6896
NPI assigned
Feb 7, 2020
Last updated
Mar 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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 RN43698 NV
Family Nurse Practitioner 363LF0000X 829103 NV Primary

Addresses

Primary practice location

2250 E Flamingo Rd
Las Vegas, NV 89119-5170

Mailing address

2250 E Flamingo Rd
Las Vegas, NV 89119-5170
Phone (702) 703-4340

Other identifiers 2

IdentifierTypeStateIssuer
RN43698OtherNVLICENSE
829103OtherNVLICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL COMPUTER Health Information Exchange (HIE)
CONNECT URL computer Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200720001753 NV Practitioner - Nurse Practitioner 3375967656 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
Las Vegas Vascular and Interventional Specialists, LLCGroup PAC ID 1557651478, 14 clinicians

Practice addresses (Care Compare)

8930 W Sunset Rd
Suite 350
Las Vegas, NV 89148-5042
Phone (702) 389-5360

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.64 of 100Reported as group
Quality
100
Improvement activities
40
Cost
58.81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Las Vegas Vascular & Interventional Specialists, LLC CurrentSince Apr 1, 2020 Accepting new patients

Locations

2250 E Flamingo Rd
Las Vegas, NV 89119
Phone (702) 474-0200

8930 W Sunset Rd
Ste 350
Las Vegas, NV 89148
Phone (702) 389-5360

9260 W Sunset Rd
Ste 201
Las Vegas, NV 89148
Phone (702) 389-5360

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1811529845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 E FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195170",
            "telephone_number": "702-703-4340",
            "fax_number": "877-951-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 E FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195170",
            "telephone_number": "702-703-4340",
            "fax_number": "877-951-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN PEDRO",
        "first_name": "MELCHOR",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN43698",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "829103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN43698",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "829103",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "COMPUTER",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2250 E Flamingo Rd",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891195170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "computer",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2250 E Flamingo Rd",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891195170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.