MS. KIMBERLY ANNE MOULLIET NURSE PRACTITIONER
NPI 1902058977
Nurse Practitioner - Family in Las Vegas, NV
About Ms. Kimberly Anne Moulliet Nurse Practitioner NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. KIMBERLY ANNE MOULLIET NURSE PRACTITIONER (NPI 1902058977) is an individual family provider in Las Vegas, Nevada, licensed in Nevada (700465) and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2008).
NPPES Registry Identity
Specialties & Licenses
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
Ms. Kimberly Anne Moulliet Nurse Practitioner 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.
Medicare Billing Reassignment
Medicare enrollment records show Kimberly Moulliet reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Placerville, CA 95667
- Reassigned Medicare billing, California enrollment
- 152 clinicians in this Medicare group
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 89103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 9
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LAS VEGAS, NV 89103
LAS VEGAS, NV 89103
LAS VEGAS, NV 89103
LAS VEGAS, NV 89103
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 Kimberly Moulliet's NPI number?
The NPI number for Kimberly Moulliet is 1902058977. It was assigned to this individual provider in the NPPES registry on October 21, 2008.
Where is Kimberly Moulliet located?
Kimberly Moulliet practices at 3835 S Jones Blvd Ste 104, Las Vegas, NV 89103. The listed phone number is (775) 570-9050.
What is Kimberly Moulliet's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kimberly Moulliet enrolled in Medicare?
Yes. Kimberly Moulliet 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 organization bills Medicare for Kimberly Moulliet's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Moulliet reassigns Medicare benefits to Marshall Medical Center (Placerville, CA). The 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 Kimberly Moulliet's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kimberly Moulliet was last updated on October 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Ms. Kimberly Anne Moulliet, NURSE PRACTITIONER · NPI 1902058977
Family physician in Las Vegas, Nevada. Individual provider, active in the CMS NPPES registry since October 21, 2008.
## Identity
- **NPI:** 1902058977 (Entity type: Individual)
- **Enumerated:** October 21, 2008
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 700465 (Nevada)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3835 S JONES BLVD STE 104, Las Vegas, NV 89103-2283
- **Phone:** (775) 570-9050
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Marshall Medical Center (NPI 1962506097, Placerville, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2008
## Record status
- **NPPES last updated:** October 11, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1902058977) · Data from the CMS NPPES public registry.