Stanley Kidiavayi, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN002072 Issued in NV

Practice address

801 S Rancho Dr Ste B1B
Las Vegas, NV 89106-3871

Phone

(702) 490-2398

Fax

(702) 912-2273

NPI assigned

Mar 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV, AZ, AK3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skidiavayi@n-nv.direct.office.nextgen.com

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.

• Good Samaritan Family Practice

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1366802159

  AZ, Family, NV

  Medicare reassignment Care Compare group NPD Authorized official
• Comprehensive Medical Group LLC

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1356131593

  Family, NV

  Medicare reassignment Care Compare group NPD
• Makini Mental Health Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1386350049

  AZ

  Medicare reassignment Authorized official
• Urgent Care Nevada, LLC

  • Urgent Care Clinic/Center
  • Henderson, NV
  • NPI 1134546575

  NV

  Medicare reassignment NPD
• Allied Clinic & Wounds LLC

  • Family Nurse Practitioner
  • Anchorage, AK
  • NPI 1720807563

  AK, Family

  Medicare reassignment NPD
• Good Samaritan Transitional Care & Wound Specialist

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1437723632

  NV

  Medicare reassignment

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

• Arrow Home Health Care Providers of Nevada LLC

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1770246167
  Care Compare affiliation
• Caring Nurses, Inc.

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1235247792
  Care Compare affiliation
• Eh Home Health of the West, LLC

  • Home Health Agency
  • Henderson, NV
  • NPI 1295129559
  Care Compare affiliation
• Eh Home Health of the West, LLC

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1841680923
  Care Compare affiliation
• St.Agatha Home Health LLC

  • Home Health Agency
  • Henderson, NV
  • NPI 1003440140
  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Comprehensive Medical Group LLC 3 clinicians

Good Samaritan Family Practice 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Las Vegas, NV, CCN 297115
• Caring Nurses Inc Home health agency, Las Vegas, NV, CCN 297068
• Enhabit Home Health (Pecos) Home health agency, Henderson, NV, CCN 297102
• Arrow Home Health Care Providers of Nevada LLC Home health agency, Las Vegas, NV, CCN 297320
• St Agatha Home Health LLC Home health agency, Henderson, NV, CCN 297271

Merit-based Incentive Payment System (MIPS)

Final score

9.15 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

30.51

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1902290968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S RANCHO DR STE B1B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063871",
            "telephone_number": "702-490-2398",
            "fax_number": "702-912-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S RANCHO DR STE B1B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063871",
            "telephone_number": "702-490-2398",
            "fax_number": "702-912-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDIAVAYI",
        "first_name": "STANLEY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "APRN002072",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Robert Kidd, MD
• Josselyn Kidd
• Rachelle L Kidd
• Kiddies Pal LLC
• Kideology, LTD
• Kidney Dialysis and Hypertension Specialists
• Selwyn A Kidney, MD
• Natalie Kido
• Kids Choice Pediatric Dentistry, LLC
• Kids Therapy LV Corporation

• All providers in Las Vegas, NV
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.