ERNESTINE PENVAGA FOMUNUNG-NGAM ARNP
NPI 1104352665
Nurse Practitioner - Family in Las Vegas, NV

Q: What is Ernestine Fomunung-ngam's NPI number?

The NPI number for Ernestine Fomunung-ngam is 1104352665. It was assigned to this individual provider in the NPPES registry on May 3, 2017. The provider is also known as Ernestine Penvaga Fomunung-Ngam.

Q: What is Ernestine Fomunung-ngam's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since May 03, 2017PECOS Enrolled

3830 E FLAMINGO RD STE 100, LAS VEGAS, NV 89121(725) 269-1044(725) 712-8163 Get Directions Write a Review

NPPES record last updated: February 10, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 27, 2021, Apr 29, 2021, Jun 29, 2017 (3 updates tracked since 2017).

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About Ernestine Penvaga Fomunung-ngam Arnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ERNESTINE PENVAGA FOMUNUNG-NGAM ARNP (NPI 1104352665) is an individual family provider in Las Vegas, Nevada, licensed in Nevada (828062) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS and maintains a secondary practice location in Las Vegas.

NPPES Registry Identity

NPI1104352665

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameERNESTINE PENVAGA FOMUNUNG-NGAMCredential: ARNP

Location Address3830 E FLAMINGO RD STE 100Las Vegas, NV 89121-6234

Mailing Address102 Woodmont Blvd Ste 600Nashville, TN 37205-5250 · (888) 987-1151

Phone(725) 269-1044

Fax(725) 712-8163

Sole ProprietorNo

Enumeration DateMay 3, 2017

Last NPPES UpdateFebruary 10, 20263 updates tracked since enumeration

NPPES CertifiedFebruary 10, 2026

✔ NPI 1104352665 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in NV · 828062✔ Licensed in FL · ARNP9310637

3830 E FLAMINGO RD STE 100, Las Vegas, NV 89121

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Other Names 1

Former Name (1)Ernestine Penvaga Fomunung-ngam

Secondary Practice Location 1

Location 12010 Wellness Way Ste 200Las Vegas, NV 89106-4142 · Phone (702) 877-0814 · Fax (702) 877-3238

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ernestine Penvaga Fomunung-ngam Arnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

170 services40 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

58 services23 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

17 services17 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89121 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.51 typical visit price

range $57.07 – $173.24

Typical copayment $22.12 (range $14.26 – $43.31)

Most-billed visit code 99203

Established Patient

$100.60 typical visit price

range $18.27 – $140.96

Typical copayment $25.15 (range $4.56 – $35.24)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER WALKER APRN

Nurse Practitioner (Family)

3830 E FLAMINGO RD STE 100
LAS VEGAS, NV 89121

Clark County (725) 269-1044

IOANA M PAHLEVAN MD

Internal Medicine

3830 E FLAMINGO RD STE 100
LAS VEGAS, NV 89121

Clark County (725) 269-1044

MARY HAO HAO DO

Family Medicine

3830 E FLAMINGO RD STE 100
LAS VEGAS, NV 89121

Clark County (725) 269-1044

JAZZMINE-ROSE BALUYOT DO

Family Medicine

3830 E FLAMINGO RD STE 100
LAS VEGAS, NV 89121

Clark County (725) 269-1044

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ernestine Fomunung-ngam's NPI number?

The NPI number for Ernestine Fomunung-ngam is 1104352665. It was assigned to this individual provider in the NPPES registry on May 3, 2017. The provider is also known as Ernestine Penvaga Fomunung-Ngam.

Where is Ernestine Fomunung-ngam located?

Ernestine Fomunung-ngam practices at 3830 E Flamingo Rd Ste 100, Las Vegas, NV 89121. The listed phone number is (725) 269-1044.

What is Ernestine Fomunung-ngam's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Ernestine Fomunung-ngam enrolled in Medicare?

Yes. Ernestine Fomunung-ngam is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ernestine Fomunung-ngam was last updated on February 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.