Individual provider Active NPI

Paula Sy, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1871281535
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
866839 Issued in NV
Practice address
825 N Gibson Rd Ste 201
Henderson, NV 89011-1708
Phone
(702) 492-1162
Fax
(702) 563-3380
NPI assigned
Apr 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 866839 NV Primary

Addresses

Primary practice location

825 N Gibson Rd Ste 201
Henderson, NV 89011-1708

Mailing address

1089 Via Della Costrella
Henderson, NV 89011-0955
Phone (702) 215-1957

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
I20230630001450 NV Practitioner - Nurse Practitioner 4284093782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Las Vegas Medical Group LLCGroup PAC ID 6800118522, 51 clinicians

Practice addresses (Care Compare)

825 N Gibson Rd
Suite 201
Henderson, NV 89011-1708
Phone (702) 492-1162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
866839NVMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Las Vegas Medical Group LLC CurrentSince Aug 14, 2023 Accepting new patients

Locations

1050 W Galleria Dr
Henderson, NV 89011
Phone (702) 723-4124

1389 Galleria Dr
Ste 100
Henderson, NV 89014
Phone (725) 333-8400

825 N Gibson Rd
Ste 201
Henderson, NV 89011
Phone (702) 492-1162

825 N Gibson Rd
Ste 301
Henderson, NV 89011
Phone (702) 763-2002

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1871281535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1089 VIA DELLA COSTRELLA",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890110955",
            "telephone_number": "702-215-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 N GIBSON RD STE 201",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890111708",
            "telephone_number": "702-492-1162",
            "fax_number": "702-563-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SY",
        "first_name": "PAULA",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NV",
            "license": "866839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.