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KELLI NISSEN
NPI 1952093692
Nurse Practitioner - Gerontology in Las Vegas, NV

Active since May 22, 2023PECOS EnrolledAccepts Medicare Assignment
7730 W CHEYENNE AVE STE 107, LAS VEGAS, NV 89129(725) 333-9218(833) 485-4980 Get Directions Write a Review

NPPES record last updated: March 15, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 15, 2026, May 2, 2024, May 22, 2023 (3 updates tracked since 2023).

About Kelli Nissen NPPES

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

KELLI NISSEN (NPI 1952093692) is an individual gerontology provider in Las Vegas, Nevada, licensed in Nevada (867835) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1952093692
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameKELLI NISSEN
Location Address7730 W CHEYENNE AVE STE 107Las Vegas, NV 89129-8412
Mailing Address7730 W Cheyenne Ave Ste 107Las Vegas, NV 89129-8412 · Fax (833) 485-4980
Phone(725) 333-9218
Fax(833) 485-4980
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateMay 22, 2023
Last NPPES UpdateMarch 15, 20263 updates tracked since enumeration
NPPES CertifiedMarch 15, 2026
✔ NPI 1952093692 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in NV · 867835
7730 W CHEYENNE AVE STE 107, Las Vegas, NV 89129
Open in Google Maps ↗

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

Kelli Nissen 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 ID547704066
PECOS Enrollment IDI20240625004493
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89129 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 3

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

TEODORO AGTAY APN
Nurse Practitioner
7730 W CHEYENNE AVE STE 107
LAS VEGAS, NV 89129
Clark County (725) 221-1568
DR. TOYA VENETTA MALONE M.D.
Psychiatry & Neurology (Neurology)
7730 W CHEYENNE AVE STE 107
LAS VEGAS, NV 89129
Clark County (725) 221-1568
MALONE-DAVIS NEUROLOGY PLLC
Psychiatry & Neurology (Neurology)
7730 W CHEYENNE AVE STE 107
LAS VEGAS, NV 89129
Clark County (725) 221-1568

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 Kelli Nissen's NPI number?

The NPI number for Kelli Nissen is 1952093692. It was assigned to this individual provider in the NPPES registry on May 22, 2023.

Where is Kelli Nissen located?

Kelli Nissen practices at 7730 W Cheyenne Ave Ste 107, Las Vegas, NV 89129. The listed phone number is (725) 333-9218.

What is Kelli Nissen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Kelli Nissen enrolled in Medicare?

Yes. Kelli Nissen 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.

When was this NPI record last updated?

The NPPES record for Kelli Nissen was last updated on March 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.