Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stanley Kidiavayi, APRN

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1902290968

Stanley Kidiavayi, APRN is a Nurse Practitioner in Las Vegas, Nevada. Qualified in 2006, 20 years ago. Practices with Comprehensive Medical Group LLC, a 3-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Nevada.

Years since qualifying
20
Licensed in
NV
In the registry since
2015
Specialties on file
2
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

801 S Rancho Dr Ste B1B
Las Vegas, NV 89106-3871
Phone: (702) 490-2398
Fax: (702) 912-2273
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN002072 (NV)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence APRN002072 (NV)

Record details

NPI number1902290968
Entity typeIndividual (Type 1)
GenderMale
Credentials APRN
Sole proprietorNo
NPI enumeratedMarch 26, 2015
Last updated in NPPESJanuary 26, 2023
Certification dateJanuary 26, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Comprehensive Medical Group Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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