Individual provider Active NPI

Camatchy Radjassegarane

  • Primary Care Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1821620469
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
828876 Issued in NV
Practice address
2653 Bad Rock Cir
Henderson, NV 89052-1000
Phone
(702) 445-9723
NPI assigned
Feb 11, 2020
Last updated
Feb 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 828876 NV Primary

Addresses

Primary practice location

2653 Bad Rock Cir
Henderson, NV 89052-1000

Mailing address

2653 Bad Rock Cir
Henderson, NV 89052-1000
Phone (702) 372-9338

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
I20200518003069 NV Practitioner - Nurse Practitioner 7618308032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mandt MSDLGroup PAC ID 5991867269, 6 clinicians

Practice addresses (Care Compare)

Las Vegas, NV 89145
Phone (702) 749-8885

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.7 of 100Reported as group
Quality
100
Improvement activities
40
Cost
68.78

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
M&T MSDL Infectious Disease CurrentSince Feb 6, 2021 Accepting new patients
Ram K Singh M D LTD CurrentSince Mar 1, 2020 Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients

Locations

1081 S Cimarron Rd
Ste B2
Las Vegas, NV 89145

1081 S Cimarron Rd
Ste B5
Las Vegas, NV 89145
Phone (702) 609-9695

4432 S Eastern Ave
Las Vegas, NV 89119
Phone (702) 733-2982

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

6900 N Durango Dr
Las Vegas, NV 89149
Phone (702) 380-1964

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

Hospital & facility affiliations 3

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": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1821620469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2653 BAD ROCK CIR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890521000",
            "telephone_number": "702-372-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 BAD ROCK CIR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890521000",
            "telephone_number": "702-445-9723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADJASSEGARANE",
        "first_name": "CAMATCHY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NV",
            "license": "828876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.