GOOD SAMARITAN FAMILY PRACTICE
NPI 1366802159
Nurse Practitioner - Family in Las Vegas, NV
About Good Samaritan Family Practice NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GOOD SAMARITAN FAMILY PRACTICE (NPI 1366802159) is a healthcare organization registered as a family in Las Vegas, Nevada and active in the NPI registry since March 2016. The organization lists Stanley M Kidiavayi, Nurse Practictioner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Good Samaritan Family Practice is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
13Medicare enrollment records show 13 clinicians reassign Medicare billing to Good Samaritan Family Practice, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 2
Clinicians, nearest first (13)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Good Samaritan Family Practice's NPI number?
The NPI number for Good Samaritan Family Practice is 1366802159. It was assigned to this organization in the NPPES registry on March 7, 2016.
Where is Good Samaritan Family Practice located?
Good Samaritan Family Practice is located at 4220 Saxton Green Avenue, Las Vegas, NV 89141. The listed phone number is (702) 400-0517.
What is Good Samaritan Family Practice's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Good Samaritan Family Practice enrolled in Medicare?
Yes. Good Samaritan Family Practice is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Good Samaritan Family Practice?
According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians in 2 Medicare specialties reassign their Medicare billing to Good Samaritan Family Practice. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (11) and Internal Medicine (2). Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Good Samaritan Family Practice accept?
Health plans from Ambetter Health and Ambetter from Arizona Complete Health list Good Samaritan Family Practice as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Good Samaritan Family Practice was last updated on March 7, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.
# Good Samaritan Family Practice · NPI 1366802159
Family organization in Las Vegas, Nevada. Organization record, active in the CMS NPPES registry since March 7, 2016.
## Identity
- **NPI:** 1366802159 (Entity type: Organization)
- **Enumerated:** March 7, 2016
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Stanley Kidiavayi, NURSE PRACTICTIONER
## Practice location
- **Address:** 4220 SAXTON GREEN AVENUE, Las Vegas, NV 89141
- **Phone:** (702) 400-0517
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 13 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (11), Internal Medicine (2); 3 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 7, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1366802159) · Data from the CMS NPPES public registry.