Individual provider Active NPI

Nikki V. Macalalad, APRN

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1922209071
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN001310 Issued in NV
Practice address
5820 S Eastern Ave
Suite 100
Las Vegas, NV 89119-3002
Phone
(702) 737-1880
Fax
(702) 737-5988
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN001310 NV Primary

Addresses

Primary practice location

5820 S Eastern Ave
Suite 100
Las Vegas, NV 89119-3002

Mailing address

PO Box 15645
Las Vegas, NV 89114-5645
Phone (702) 737-1880

Other identifiers 1

IdentifierTypeStateIssuer
1922209071MedicaidNV

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
I20111011000514 NV Practitioner - Nurse Practitioner 8022180397 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group Rhodes P C CurrentSince Jun 10, 2019 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Jun 10, 2019 Accepting new patients
Southwest Medical Associates, Inc CurrentSince Sep 12, 2011 Accepting new patients

Locations

300 E Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 435-4301

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

5820 S Eastern Ave
Ste 100
Las Vegas, NV 89119
Phone (702) 737-1880

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1922209071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "702-737-1880",
            "fax_number": "702-737-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 S EASTERN AVE",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891193002",
            "telephone_number": "702-737-1880",
            "fax_number": "702-737-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACALALAD",
        "first_name": "NIKKI",
        "middle_name": "V.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APN001310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922209071",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.