Look up the most recent NPI and PECOS records

Ida Praile Sorongon

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

3343 S Easterm Avenue, Las Vegas, NV 89169

PECOS Enrollment

This provider is enrolled in PECOS as IDA SORONGON.

Based on the most recent information from CMS, provider Ida Praile Sorongon is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 10:46 AM.

Profile Details

Provider ID
1700225844
Provider Type
Individual
Full Name
Sorongon, Ida Praile
Credential
NURSE PRACTITIONER

Gender
Female
Sole Proprietor
No
Enumeration Date
6/21/2013
Last Updated
10/9/2019

Contact Information

Practice Location

3343 S Easterm Avenue, Las Vegas, NV 89169

(702) 731-0909

(702) 731-1020

Mailing Location

8936 Spanish Ridge Ave, Las Vegas, NV 89148-1354

(702) 998-2816

(702) 998-2991

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License APN001519 Nevada

Provider Identifiers

ID	Description	Issuer
ID 1700225844	Description Medicaid	Issuer Unlisted Nevada

Ida Praile Sorongon

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

I & E Respiratory Services Inc.

Ley Rojo, Alex

Marquez De Rozakis, Alejandra

Martins, Kristina Grevyte

Kawi, Jennifer

Sapphire Medical Group Inc

Fiesta, Zonia Dumlao

Zonia Fiesta Aprn Llc

Pfeiffer, Amy Martine

Relucio, Ruth Alma Vanessa Lim