Individual provider Active NPI

Paul J Kapsar Jr., APN

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1952322497
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN000904 Issued in NV
Practice address
4560 S Eastern Ave Ste 14
Las Vegas, NV 89119-6182
Phone
(702) 586-5060
Fax
(702) 463-7377
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X UP005949B PA
Family Nurse Practitioner 363LF0000X APN000904 NV Primary

Addresses

Primary practice location

4560 S Eastern Ave Ste 14
Las Vegas, NV 89119-6182

Mailing address

4560 S Eastern Ave Ste 14
Las Vegas, NV 89119-6182
Phone (702) 586-5060

Other identifiers 2

IdentifierTypeStateIssuer
104928OtherFROM UMC
100512687MedicaidNV

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
I20071207000590 NV Practitioner - Nurse Practitioner 8022090604

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN000904NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Well Pathways LLC Family Current Accepting new patients
I.C.a.N. Family Services LLC PastSince Aug 18, 2019 Accepting new patients

Locations

2560 E Sunset Rd
Ste 120
Las Vegas, NV 89120
Phone (702) 541-6023

Interoperability endpoints

  • Direct secure messaging: pkaspar@snvbc.adaptamed.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1952322497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 S EASTERN AVE STE 14",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196182",
            "telephone_number": "702-586-5060",
            "fax_number": "702-463-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 S EASTERN AVE STE 14",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196182",
            "telephone_number": "702-586-5060",
            "fax_number": "702-463-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPSAR",
        "first_name": "PAUL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "UP005949B",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APN000904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FROM UMC",
            "identifier": "104928",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100512687",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.