Active NPI
John Marius Agravio Tolentino, APRN, FNP-C
- Family Nurse Practitioner
- Las Vegas, NV
National Provider Identifier
1851990840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 835286
- Practice address
- 3557 Winter Wren St
Las Vegas, NV 89122-3539 - Phone
- (702) 445-4092
- NPI assigned
- Oct 21, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 835286 | NV | Primary |
Addresses
Primary practice location
3557 Winter Wren St
Las Vegas, NV 89122-3539
Mailing address
5510 S Fort Apache Rd Ste 13
Las Vegas, NV 89148-7700
Phone (702) 268-8900
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthy Lifeline LLC | Family | Current | Accepting new patients |
| Community Medicine Inc. | Single Specialty | Past | Accepting new patients |
| True North Health Navigation LLC | Single Specialty | Past | Accepting new patients |
| Silver Healthcare Solutions LLC | Single Specialty | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Family Nurse Practitioner
- Las Vegas, NV
- NPI 1487197091
Single Specialty
-
- Emergency Medicine Physician
- Denver, CO
- NPI 1740622133
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707782400000",
"number": "1851990840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5510 S FORT APACHE RD STE 13",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891487700",
"telephone_number": "702-268-8900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3557 WINTER WREN ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891223539",
"telephone_number": "702-445-4092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLENTINO",
"first_name": "JOHN MARIUS",
"middle_name": "AGRAVIO",
"credential": "APRN, FNP-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-21",
"last_updated": "2024-02-13",
"certification_date": "2024-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "NV",
"license": "835286",
"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 Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.