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GOOD SAMARITAN FAMILY PRACTICE
NPI 1366802159
Nurse Practitioner - Family in Las Vegas, NV

Active since March 07, 2016
4220 SAXTON GREEN AVENUE, LAS VEGAS, NV 89141(702) 400-0517 Get Directions Write a Review

NPPES record last updated: March 7, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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

NPI1366802159
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameGOOD SAMARITAN FAMILY PRACTICE
Location Address4220 SAXTON GREEN AVENUELas Vegas, NV 89141
Mailing Address4220 Saxton Green AveLas Vegas, NV 89141-4354 · (702) 400-0517
Phone(702) 400-0517
Organization SubpartNo
Authorized OfficialStanley M KidiavayiNurse Practictioner · (702) 400-0517
Enumeration DateMarch 7, 2016
✔ NPI 1366802159 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 · APRN002072
4220 SAXTON GREEN AVENUE, Las Vegas, NV 89141
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

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

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.

What insurance does Good Samaritan Family Practice accept?

Health plans from 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.