GOOD SAMARITAN FAMILY PRACTICE SOS Verified
4220 SAXTON GREEN AVENUE, LAS VEGAS, NV 89141
NPI Number
1366802159
SOS Verification: Verified
Entity Name: GOOD SAMARITAN FAMILY PRACTICE LLC.
Entity Number: E0084202016-6
Entity Type: Domestic Limited-Liability Company
Entity Status: Active
Formation Date: 2016-02-23
Name Match: 90%
Registered Agent
Name: NVRA SERVICES, INC.
Type: Commercial Registered Agent
Address: 120 HWY 50 STE 1, Dayton, NV, 89403
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Manager | STANLEY KIDIAVAYI | 4220 SAXTON GREEN, LAS VEGAS, NV, 89141 | Active |
Campaign Contributions
$200Total Contributed
1Candidates Supported
Officer / Individual Matches
Stanley KidiavayiConfirmed Match
Matched via officer: STANLEY KIDIAVAYI (Manager)
$200 across 1 contribution
| Candidate | Office | Party | Total | Count |
|---|---|---|---|---|
| Reuben D'Silva | State Assembly, District 28 | Democratic Party | $200 | 1 |
Data Notice Campaign contribution matches are based on automated name matching against Nevada Secretary of State campaign finance records. Corporate matches compare registered business names. Officer matches compare individual names and may include false positives due to common names. Contributions are to Nevada state and local candidates only.
Total Medicaid Payments
$216,450
+252% vs specialty average
Patients Seen
15,813
Total Claims
17,234
$ Per Patient
$14
Specialty avg: $33
Specialty Rank
#24 of 244
Nurse Practitioner, Family providers in Nevada
Peer Average
$61,530
Average total for Nurse Practitioner, Family
Claims per Patient
1.1
Average visits / services per person
Payments by Year
How much Medicaid paid this provider each year. Large jumps can indicate changes in practice volume or billing patterns.
| Year | Total Paid | % of Max |
|---|---|---|
| 2018 | $3,557 | |
| 2019 | $33,349 | |
| 2020 | $81,186 | |
| 2021 | $85,334 | |
| 2022 | $11,843 | |
| 2023 | $1,181 | |
| 2024 | $0 |
Procedure Code Breakdown
The specific medical services this provider billed Medicaid for. Each HCPCS/CPT code represents a different type of visit, test, or treatment.
| HCPCS Code | Description | Claims | Paid | % of Total | Avg per Claim |
|---|---|---|---|---|---|
| 99349 | Home visit follow-up — complex problem | 2,780 | $50,724 | 23.4% | $18 |
| 99214 | Office visit for a moderate problem (established patient) | 2,093 | $44,861 | 20.7% | $21 |
| G0181 | Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidiscip... | 2,452 | $44,690 | 20.6% | $18 |
| 99091 | Special medical service | 1,740 | $17,207 | 7.9% | $10 |
| 99344 | Home visit — serious, comprehensive problem | 303 | $12,348 | 5.7% | $41 |
| G0179 | Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present) | 1,060 | $9,631 | 4.4% | $9 |
| 99213 | Office visit for a simple problem (established patient) | 702 | $8,763 | 4.0% | $12 |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present) | 610 | $5,725 | 2.6% | $9 |
| 99497 | Medical service or procedure | 351 | $4,498 | 2.1% | $13 |
| 99496 | Medical service or procedure | 129 | $3,978 | 1.8% | $31 |
| 99336 | Medical service or procedure | 59 | $2,548 | 1.2% | $43 |
| 99358 | Medical service or procedure | 149 | $2,045 | 0.9% | $14 |
| 99487 | Complex chronic care management — for patients with very complicated health needs | 69 | $1,248 | 0.6% | $18 |
| 99490 | Chronic care management — monthly coordination for patients with multiple ongoing conditions | 965 | $1,183 | 0.5% | $1 |
| 99335 | Medical service or procedure | 49 | $1,064 | 0.5% | $22 |
| 99204 | New patient office visit — detailed visit for a serious problem | 47 | $967 | 0.4% | $21 |
| G0439 | Annual wellness visit — follow-up | 118 | $728 | 0.3% | $6 |
| 99454 | Medical service or procedure | 67 | $663 | 0.3% | $10 |
| 99489 | Complex chronic care management — additional 30 minutes | 69 | $658 | 0.3% | $10 |
| 99212 | Office visit for a minor problem (established patient) | 70 | $637 | 0.3% | $9 |
| 99457 | Medical service or procedure | 69 | $614 | 0.3% | $9 |
| 99439 | Medical service or procedure | 888 | $586 | 0.3% | $1 |
| 99458 | Medical service or procedure | 79 | $399 | 0.2% | $5 |
| 99343 | Home visit — complex problem | 15 | $331 | 0.2% | $22 |
| 99354 | Medical service or procedure | 15 | $293 | 0.1% | $20 |
| 99453 | Medical service or procedure | 31 | $61 | 0.0% | $2 |
| 99350 | Home visit follow-up — unstable condition | 23 | $0 | 0.0% | $0 |
| G0438 | Annual wellness visit — first time | 12 | $0 | 0.0% | $0 |
| G9459 | Currently a tobacco non-user | 31 | $0 | 0.0% | $0 |
| 1111F | Medical service or procedure | 113 | $0 | 0.0% | $0 |
| 1123F | Medical service or procedure | 30 | $0 | 0.0% | $0 |
| G9621 | Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling | 247 | $0 | 0.0% | $0 |
| G9458 | Patient documented as tobacco user and received tobacco cessation intervention (must include at least one of the following: advice given to quit smoking or tobacco use | 209 | $0 | 0.0% | $0 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 1,452 | $0 | 0.0% | $0 |
| 99348 | Home visit follow-up — moderate problem | 126 | $0 | 0.0% | $0 |
| 99406 | Medical service or procedure | 12 | $0 | 0.0% | $0 |
About This Data
This data comes from the HHS Medicaid Provider Spending dataset (opendata.hhs.gov). It shows payments made through Nevada Medicaid from 2018–2024. High payments do not mean a provider is doing anything wrong — some specialties naturally cost more, and busy providers see more patients. But unusually high numbers compared to peers can be worth a closer look.