| Good Samaritan Transitional Care & Wound Specialist | |
|
1500 E Tropicana Ave Ste 161 Las Vegas NV 89119-6516 | |
| (702) 334-2166 | |
| (702) 462-2326 |
| Full Name | Good Samaritan Transitional Care & Wound Specialist |
|---|---|
| Speciality | Family Medicine |
| Location | 1500 E Tropicana Ave Ste 161, Las Vegas, Nevada |
| Authorized Official Name and Position | Nathan Barile (MANAGER) |
| Authorized Official Contact | 9515001993 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Samaritan Transitional Care & Wound Specialist 1500 E Tropicana Ave Ste 161 Las Vegas NV 89119-6516 Ph: (702) 334-2166 | Good Samaritan Transitional Care & Wound Specialist 1500 E Tropicana Ave Ste 161 Las Vegas NV 89119-6516 Ph: (702) 334-2166 |
| NPI Number | 1437723632 |
|---|---|
| Provider Enumeration Date | 05/13/2021 |
| Last Update Date | 05/21/2021 |
| Medicare PECOS PAC ID | 1850796889 |
|---|---|
| Medicare Enrollment ID | O20210830000269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437723632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Stanley Kidiavayi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902290968 PECOS PAC ID: 7416259551 Enrollment ID: I20160506000245 |
| Provider Name | Joan Lou Paras Nakar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275172173 PECOS PAC ID: 0042554495 Enrollment ID: I20200706000181 |
| Provider Name | Maria Jill Buena Alfonso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982332227 PECOS PAC ID: 7618340597 Enrollment ID: I20230223000455 |
| Provider Name | Sheila Villacrucis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659083392 PECOS PAC ID: 5698148906 Enrollment ID: I20230323001449 |
| Provider Name | Princess Pangilinan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497432785 PECOS PAC ID: 1759735095 Enrollment ID: I20230920003371 |
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