KELLY BUCALO (APRN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1992367080
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,947 NURSE PRACTITIONER in NV
Provider Addresses for KELLY BUCALO (APRN)
1180 N Town Center Dr Ste 100
Las Vegas, NV 891446308
Phone: (702) 475-2277
Type: Location
911 N BUFFALO DR UNIT 213
LAS VEGAS, NV 891280381
Phone: (702) 405-8088
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $130.
Total Amount is formed as General ($130) + Research ($0) + Ownership ($0) = $130.
Last reported payment date: 2023-06-01 • Largest payer in this snapshot: ITI, Inc. ($130).
Total Amount
$130
General + Research + Ownership
Payments
1
Total payment records
General Amount
$130
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-01
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ITI, Inc. | $130 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-08-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190806003073 | I | Nurse Practitioner | NV | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 51 | 12 | $0 |
Insurance plans in this area (ZIP 89144)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | NV | |
| Clinical Social Worker | NV | |
| Clinical Social Worker | NV |
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