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MRS. EBONY SHANDREKA PETERSON FNP-BC, PMHNP-BC
NPI 1396293841
Nurse Practitioner - Family in Las Vegas, NV

Active since September 13, 2016PECOS EnrolledAccepts Medicare Assignment
2575 S CIMARRON RD STE 104, LAS VEGAS, NV 89117(725) 712-4625(725) 262-5536 Get Directions Write a Review

NPPES record last updated: October 21, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 18, 2024, Nov 6, 2023, Nov 4, 2023 and 4 more (7 updates tracked since 2016).

About Mrs. Ebony Shandreka Peterson Fnp-bc, Pmhnp-bc NPPES

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

MRS. EBONY SHANDREKA PETERSON FNP-BC, PMHNP-BC (NPI 1396293841) is an individual family provider in Las Vegas, Nevada, licensed in Nevada (821513) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1396293841
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. EBONY SHANDREKA PETERSONCredential: FNP-BC, PMHNP-BC
Location Address2575 S CIMARRON RD STE 104Las Vegas, NV 89117-2682
Mailing Address2575 S Cimarron Rd Ste 104Las Vegas, NV 89117-2682 · (725) 712-4625 · Fax (725) 262-5536
Phone(725) 712-4625
Fax(725) 262-5536
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateSeptember 13, 2016
Last NPPES UpdateOctober 21, 20257 updates tracked since enumeration
NPPES CertifiedOctober 21, 2025
✔ NPI 1396293841 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NV · 821513
Also ListedNurse PractitionerTaxonomy 363L00000X · License 821513 (NV)
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License 821513 (NV)
2575 S CIMARRON RD STE 104, Las Vegas, NV 89117
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Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Ebony Shandreka Peterson Fnp-bc, Pmhnp-bc 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 ID9133417645
PECOS Enrollment IDI20200319002443
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Ebony Peterson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hill Care LLC
Same address
Family Medicine
2575 S CIMARRON RD STE 104
Las Vegas, NV 89117
  • Reassigned Medicare billing, Nevada enrollment
  • 6 clinicians in this Medicare group
NPI 1871291872 (725) 712-4625
Deepa Hasija MD
8.2 mi
Child & Adolescent Psychiatry
4055 SPENCER ST STE 106
Las Vegas, NV 89119
  • Reassigned Medicare billing, Nevada enrollment
  • 10 clinicians in this Medicare group
NPI 1841721917 (702) 582-8705

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89117 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 5

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

SONIA WYATT
Behavior Analyst
2575 S CIMARRON RD STE 104
LAS VEGAS, NV 89117
Clark County (702) 476-2899
HILL CARE LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
2575 S CIMARRON RD STE 104
LAS VEGAS, NV 89117
Clark County (725) 712-4625
A NOVO CARE
Home Health
2575 S CIMARRON RD STE 104
LAS VEGAS, NV 89117
Clark County (702) 476-2899
HILL CARE LLC
Family Medicine
2575 S CIMARRON RD STE 104
LAS VEGAS, NV 89117
Clark County (725) 712-4625
KATHERINE BOLANOS LCSW
Social Worker (Clinical)
2575 S CIMARRON RD STE 104
LAS VEGAS, NV 89117
Clark County (725) 712-4625

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 Ebony Peterson's NPI number?

The NPI number for Ebony Peterson is 1396293841. It was assigned to this individual provider in the NPPES registry on September 13, 2016.

Where is Ebony Peterson located?

Ebony Peterson practices at 2575 S Cimarron Rd Ste 104, Las Vegas, NV 89117. The listed phone number is (725) 712-4625.

What is Ebony Peterson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Ebony Peterson enrolled in Medicare?

Yes. Ebony Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Ebony Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ebony Peterson reassigns Medicare benefits to 2 organizations: Hill Care LLC (Las Vegas, NV) and Deepa Hasija MD (Las Vegas, NV). Each 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 Ebony Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ebony Peterson accept?

Health plans from Ambetter Health and Ambetter from Arizona Complete Health list Ebony Peterson 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 Ebony Peterson was last updated on October 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.