NPIMap

Individual provider Active NPI

Ketan Kantilal Thanki, M.D.

  • Colon & Rectal Surgery Physician
  • Las Vegas, NV
National Provider Identifier
1093058869
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
21638 Issued in NV
Practice address
5320 S Rainbow Blvd Ste 302
Las Vegas, NV 89118-1896
Phone
(702) 382-8222
Fax
(702) 563-3390
NPI assigned
Mar 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 21638 NV
Colon & Rectal Surgery Physician 208C00000X A203266 CA
Colon & Rectal Surgery Physician 208C00000X 21638 NV Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5320 S Rainbow Blvd Ste 302
Las Vegas, NV 89118-1896

Mailing address

367 S Gulph Rd
King of Prussia, PA 19406-3121
Phone (702) 382-8222

Other practice location 1

2810 Long Beach Blvd Fl 3
Long Beach, CA 90806-1558
Phone (562) 933-4752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211215001522 NV Practitioner - General Surgery 1850782475 Reassigns benefits to 1 organization
I20250910002567 CA Practitioner - Colorectal Surgery (Proctology) 1850782475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Las Vegas Medical Group LLCGroup PAC ID 6800118522, 51 clinicians

Practice addresses (Care Compare)

1389 Galleria Dr
Suite 100
Henderson, NV 89014-6686
Phone (725) 333-8400

2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 728-5034

825 N Gibson Rd
Suite 201
Henderson, NV 89011-1708
Phone (702) 492-1162

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A203266CAMDColon & Rectal Surgery Physician
21638NVMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group Current Accepting new patients
Las Vegas Medical Group LLC Surgery CurrentSince Dec 13, 2021 Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Prohealth Partners a Medical Group CurrentSince Oct 1, 2025 Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Prohealth Partners a Medical Group Inc Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

1389 Galleria Dr
Ste 100
Henderson, NV 89014
Phone (725) 333-8400

5320 S Rainbow Blvd
Ste 302
Las Vegas, NV 89118
Phone (702) 382-8222

367 S Gulph Rd
Kng of Prussa, PA 19406
Phone (610) 382-4422

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kthanki920861@direct.memorialcare.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1093058869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S GULPH RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "702-382-8222",
            "fax_number": "702-563-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 S RAINBOW BLVD STE 302",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181896",
            "telephone_number": "702-382-8222",
            "fax_number": "702-563-3390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2810 Long Beach Blvd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908061558",
            "country_code": "US",
            "telephone_number": "562-933-4752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THANKI",
        "first_name": "KETAN",
        "middle_name": "KANTILAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-30",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "21638",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "A203266",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NV",
            "license": "21638",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.