NICHOLAS STEPHEN FORTNA DO
NPI 1215739180
Student in an Organized Health Care Education/Training Program in Las Vegas, NV

Q: What is Nicholas Fortna's NPI number?

The NPI number for Nicholas Fortna is 1215739180. It was assigned to this individual provider in the NPPES registry on March 24, 2025.

Q: What is Nicholas Fortna's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Fortna was last updated on June 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since March 24, 2025PECOS Enrolled

3014 W CHARLESTON BLVD STE 130, LAS VEGAS, NV 89102(702) 671-5127 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 4, 2026, Sep 6, 2025, Mar 28, 2025 (3 updates tracked since 2025).

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About Nicholas Stephen Fortna Do NPPES

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

NICHOLAS STEPHEN FORTNA DO (NPI 1215739180) is an individual student in an organized health care education/training program in Las Vegas, Nevada and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215739180

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameNICHOLAS STEPHEN FORTNACredential: DO

Location Address3014 W CHARLESTON BLVD STE 130Las Vegas, NV 89102-0083

Mailing Address3014 W Charleston Blvd Ste 130Las Vegas, NV 89102-0083

Phone(702) 671-5127

Sole ProprietorNo

Enumeration DateMarch 24, 2025

Last NPPES UpdateJune 4, 20263 updates tracked since enumeration

NPPES CertifiedJune 4, 2026

✔ NPI 1215739180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License SL2352 (NV)

3014 W CHARLESTON BLVD STE 130, Las Vegas, NV 89102

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicholas Stephen Fortna Do 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.

Other Providers at the Same Location NPPES 20

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

JOSHUA JAMES EREDICS DO

Student in an Organized Health Care Education/Training Program