Saint Jude Medical Group LLC Home Doctors
NPI 1730713611ActiveOrganization· Nurse Practitioner· Henderson, NV
Nurse Practitioner in Henderson, Nevada, registered in NPPES in February 2020. The authorized official on file is Nerissa Dimailig, APRN, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1730713611 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 28, 2020 |
| Last updated in NPPES | Mar 19, 2026 |
| Certified by provider | Mar 19, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
| Clinic/Center, Primary Care | 261QP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NV) |
|---|
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