MRS. IVANA P. FUKUMOTO NP-C
NPI 1114234630
Nurse Practitioner - Family in Henderson, NV

Active since September 03, 2010PECOS Enrolled
2350 CORPORATE CIR STE 201, HENDERSON, NV 89074(702) 562-8900(702) 407-0266 Get Directions Write a Review

NPPES record last updated: May 21, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 21, 2026, Jun 20, 2025, Nov 3, 2022 and 2 more (5 updates tracked since 2016).

About Mrs. Ivana P. Fukumoto Np-c NPPES

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

MRS. IVANA P. FUKUMOTO NP-C (NPI 1114234630) is an individual family provider in Henderson, Nevada, licensed in Nevada (APN001217) and active in the NPI registry since September 2010. She is enrolled in Medicare PECOS and maintains a secondary practice location in Las Vegas.

NPPES Registry Identity

NPI1114234630
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. IVANA P. FUKUMOTOCredential: NP-C
Location Address2350 CORPORATE CIR STE 201Henderson, NV 89074-7737
Mailing Address6355 S Buffalo Dr Fl 3Las Vegas, NV 89113-2133 · (702) 216-3346
Fax(702) 407-0266
Sole ProprietorNo
Enumeration DateSeptember 3, 2010
Last NPPES UpdateMay 21, 20265 updates tracked since enumeration
NPPES CertifiedMay 21, 2026
NPI 1114234630 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
License Licensed in NV · APN001217
2350 CORPORATE CIR STE 201, Henderson, NV 89074

Secondary Practice Location 1

Location 11799 Mount Mariah DrLas Vegas, NV 89106-1501 · Phone (800) 787-2568

Other Identifiers 2

OtherAPRN001217NV · License
Medicaid1114234630NV

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Mrs. Ivana P. Fukumoto Np-c 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89074 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 2

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

Pediatrics
2350 CORPORATE CIR STE 201
HENDERSON, NV 89074
Pediatrics
2350 CORPORATE CIR STE 201
HENDERSON, NV 89074

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114234630, enumerated as an "individual" on September 03, 2010.

The provider is located at 2350 CORPORATE CIR STE 201 HENDERSON, NV 89074 and the phone number is (702) 562-8900.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Medicare. Please consult your insurance carrier or call the provider to verify.