Individual provider Active NPI

John Paolo Estanisalo Domingo, APRN

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1982320966
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
816856 Issued in NV
Practice address
9320 W Sahara Ave
Las Vegas, NV 89117-5351
Phone
(702) 383-3850
NPI assigned
Oct 12, 2022
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 816856 NV Primary

Addresses

Primary practice location

9320 W Sahara Ave
Las Vegas, NV 89117-5351

Mailing address

9320 W Sahara Ave
Las Vegas, NV 89117-5351
Phone (702) 383-3850

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
I20221119000496 NV Practitioner - Nurse Practitioner 0042688277 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carefirst Urgent Care LLCGroup PAC ID 3779901939, 20 clinicians

Practice addresses (Care Compare)

4360 Blue Diamond Rd
Suite 103
Las Vegas, NV 89139-7785
Phone (513) 847-6778

9320 W Sahara Ave
Las Vegas, NV 89117-5351
Phone (702) 383-3850

Merit-based Incentive Payment System (MIPS)

Final score
98.01 of 100Reported as apm
Quality
84.78
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carefirst Urgent Care, LLC CurrentSince Oct 12, 2022 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Sep 30, 2024 Accepting new patients
Clinic 21 of Nevada Zyniewicz PLLC CurrentSince Oct 1, 2022 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Sep 30, 2024 Accepting new patients
CG Medical Associates Inc Past Accepting new patients

Locations

525 Marks St
Henderson, NV 89014
Phone (702) 383-6210

1700 Wheeler Peak Dr
Las Vegas, NV 89106
Phone (702) 383-2565

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

2031 N Buffalo Dr
Las Vegas, NV 89128
Phone (702) 383-2650

4180 S Rainbow Blvd
Ste 810
Las Vegas, NV 89103
Phone (702) 383-3626

4360 Blue Diamond Rd
Ste 103
Las Vegas, NV 89139
Phone (702) 407-0524

4760 Blue Diamond Rd
Ste 110
Las Vegas, NV 89139
Phone (702) 383-2300

5216 Boulder Hwy
Ste 105
Las Vegas, NV 89122
Phone (513) 846-6778

5785 Centennial Center Blvd
Ste 190
Las Vegas, NV 89149
Phone (702) 383-6270

61 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 383-6240

9320 W Sahara Ave
Las Vegas, NV 89117
Phone (702) 383-3633

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1982320966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 W SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175351",
            "telephone_number": "702-383-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 W SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175351",
            "telephone_number": "702-383-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "JOHN PAOLO",
        "middle_name": "ESTANISALO",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-12",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "816856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.