Individual provider Active NPI

Mark Gordon Vallejo Salvador, APRN, NP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1841667417
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN002017 Issued in NV
Practice address
6352 Medical Center St
Las Vegas, NV 89148-2413
Phone
(702) 541-6200
NPI assigned
Aug 30, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN002017 NV Primary

Addresses

Primary practice location

6352 Medical Center St
Las Vegas, NV 89148-2413

Mailing address

10624 S Eastern Ave
Apt 3-205
Henderson, NV 89052-2982
Phone (702) 407-7700

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
I20160430000009 NV Practitioner - Nurse Practitioner 8325347073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Platinum Hospitalists LLPGroup PAC ID 7214076322, 197 clinicians

Practice addresses (Care Compare)

5495 S Rainbow Blvd
Suite 202
Las Vegas, NV 89118-1873
Phone (725) 205-1249

7495 W Azure Dr
Suite 209
Las Vegas, NV 89130-4440
Phone (702) 407-7700

Hospital & facility affiliations

  • Valley Health at Home by Bayada Home health agency, Las Vegas, NV, CCN 297106

Merit-based Incentive Payment System (MIPS)

Final score
61.15 of 100Reported as group
Quality
36.67
Improvement activities
40
Cost
61.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN002017NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Platinum Hospitalists LLP CurrentSince Apr 1, 2016 Accepting new patients
Platinum Hospitalists LLP CurrentSince Apr 1, 2016 Accepting new patients

Locations

10624 S Eastern Ave
Ste A995
Henderson, NV 89052

10624 S Eastern Ave
#A955
Henderson, NV 89052
Phone (702) 407-7700

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

7495 W Azure Dr
Ste 209
Las Vegas, NV 89130
Phone (702) 327-6653

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1440892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1841667417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE",
            "address_2": "APT 3-205",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-407-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6352 MEDICAL CENTER ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891482413",
            "telephone_number": "702-541-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALVADOR",
        "first_name": "MARK GORDON",
        "middle_name": "VALLEJO",
        "credential": "APRN, NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-30",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.