Individual provider Active NPI

Tammy Collander

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1952779449
Registry record updated Feb 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN002035 Issued in NV
Practice address
2831 Business Park CT # 130a
Las Vegas, NV 89128-9007
Phone
(702) 844-4848
Fax
(702) 844-4849
NPI assigned
Sep 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN55701 NV
Family Nurse Practitioner 363LF0000X APRN002035 NV Primary

Addresses

Primary practice location

2831 Business Park CT # 130a
Las Vegas, NV 89128-9007

Mailing address

2370 Corporate Cir Ste 300
Henderson, NV 89074-7760
Phone (702) 910-3950

Other names 1

  • Tammy L Molina Former name

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
I20151022001365 NV Practitioner - Nurse Practitioner 5597074120 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

2704 N Tenaya Way
Las Vegas, NV 89128-0424
Phone (702) 579-3253

2716 N Tenaya Way
Las Vegas, NV 89128-0424
Phone (702) 579-3253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN55701NVMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group II Rhodes P C CurrentSince Dec 1, 2022 Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients
Bacchus PC CurrentSince Jan 18, 2021 Accepting new patients
Physicians Medical Center Kaufman, LTD Past Accepting new patients
P3 Health Partners Professional Services PC Past Accepting new patients

Locations

100 N Green Valley Pkwy
Ste 239
Henderson, NV 89074
Phone (702) 844-4841

2370 Corporate Cir
Ste 300
Henderson, NV 89074
Phone (702) 910-3950

653 N Town Center Dr
Ste 106
Las Vegas, NV 89144
Phone (702) 363-3000

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

360 S Lola Ln
Bldg B
Pahrump, NV 89048
Phone (775) 505-0810

Interoperability endpoints

  • Direct secure messaging: tcollander120867@westdirect.optum.com

Organizations & group practices 5

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": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612569600000",
    "number": "1952779449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 CORPORATE CIR STE 300",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747760",
            "telephone_number": "702-910-3950",
            "fax_number": "702-352-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 BUSINESS PARK CT # 130A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891289007",
            "telephone_number": "702-844-4848",
            "fax_number": "702-844-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLANDER",
        "first_name": "TAMMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-14",
        "last_updated": "2021-02-06",
        "certification_date": "2021-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN55701",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "MOLINA",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.