DOMINIC MASON ETLI APRN
NPI 1962934885
Nurse Practitioner in Las Vegas, NV

Q: What is Dominic Etli's NPI number?

The NPI number for Dominic Etli is 1962934885. It was assigned to this individual provider in the NPPES registry on March 30, 2017.

Q: What is Dominic Etli's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Dominic Etli was last updated on December 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since March 30, 2017PECOS Enrolled

540 N NELLIS BLVD, LAS VEGAS, NV 89110(702) 877-5199 Get Directions Write a Review

NPPES record last updated: December 22, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 22, 2021, Jul 31, 2019, Mar 30, 2017 (3 updates tracked since 2017).

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About Dominic Mason Etli Aprn NPPES

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

DOMINIC MASON ETLI APRN (NPI 1962934885) is an individual nurse practitioner in Las Vegas, Nevada, licensed in Nevada (APRN002559) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS and maintains a secondary practice location in Las Vegas.

NPPES Registry Identity

NPI1962934885

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameDOMINIC MASON ETLICredential: APRN

Location Address540 N NELLIS BLVDLas Vegas, NV 89110-5368

Mailing Address509 Ruby Vista CtLas Vegas, NV 89144-4101

Phone(702) 877-5199

Sole ProprietorNo

Enumeration DateMarch 30, 2017

Last NPPES UpdateDecember 22, 20213 updates tracked since enumeration

NPPES CertifiedDecember 22, 2021

✔ NPI 1962934885 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in NV · APRN002559

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered NurseTaxonomy 163W00000X · License 74214 (NV)

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 002559 (NV)

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License APRN002559 (NV)

540 N NELLIS BLVD, Las Vegas, NV 89110

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Secondary Practice Location 1

Location 19010 W Cheyenne AveLas Vegas, NV 89129-8932 · Phone (702) 240-8646 · Fax (702) 932-8347

Other Identifiers 1

OtherV59731NV · Medicare

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dominic Mason Etli Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 89110 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 20

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

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