MR. MARIO OLIVER TABLANTE GODOY APRN NP-C
NPI 1275822611
Nurse Practitioner - Primary Care in Las Vegas, NV

Q: What is Mario Oliver Godoy's NPI number?

The NPI number for Mario Oliver Godoy is 1275822611. It was assigned to this individual provider in the NPPES registry on April 6, 2011.

Q: What is Mario Oliver Godoy's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Active since April 06, 2011PECOS EnrolledAccepts Medicare Assignment

1706 W BONANZA RD, LAS VEGAS, NV 89106(702) 631-6860(702) 631-6864 Get Directions Write a Review

NPPES record last updated: February 10, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 9, 2025, Sep 2, 2020 (2 updates tracked since 2020).

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About Mr. Mario Oliver Tablante Godoy Aprn Np-c NPPES

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

MR. MARIO OLIVER TABLANTE GODOY APRN NP-C (NPI 1275822611) is an individual primary care provider in Las Vegas, Nevada, licensed in Nevada (APRN001258) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS and is a graduate of Other (1995).

NPPES Registry Identity

NPI1275822611

Entity TypeIndividualMale

Primary Taxonomy363LP2300X

Provider Legal NameMR. MARIO OLIVER TABLANTE GODOYCredential: APRN NP-C

Location Address1706 W BONANZA RDLas Vegas, NV 89106-4704

Mailing Address8010 Bradley RdLas Vegas, NV 89131-2016 · (702) 239-9123

Phone(702) 631-6860

Fax(702) 631-6864

Sole ProprietorNo

Medical School CMSOtherGraduated 1995

Enumeration DateApril 6, 2011

Last NPPES UpdateFebruary 10, 20262 updates tracked since enumeration

NPPES CertifiedFebruary 10, 2026

✔ NPI 1275822611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

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

Taxonomy Code363LP2300X

License✔ Licensed in NV · APRN001258

Also ListedRegistered NurseTaxonomy 163W00000X · License RN67477 (NV)

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License APRN001258 (NV)

1706 W BONANZA RD, Las Vegas, NV 89106

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Mario Oliver Tablante Godoy Aprn Np-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103141874

PECOS Enrollment IDI20150223000016

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 6

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.

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

174 services12 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

110 services38 patients

Injection, ketorolac tromethamine, per 15 mg J1885

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

76 services11 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

57 services15 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

17 services17 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89106 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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

4 suppliers11 claims16 services$4.96 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 6

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

ALANAI JOHNSON RN

Registered Nurse