Individual provider Active NPI

Caroline Nguyen, M.D.

  • Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1104113471
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
15854 Issued in NV
Practice address
3201 S Maryland Pkwy
Ste 608
Las Vegas, NV 89109-2441
Phone
(702) 457-5437
NPI assigned
Jul 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 15854 NV Primary

Addresses

Primary practice location

3201 S Maryland Pkwy
Ste 608
Las Vegas, NV 89109-2441

Mailing address

3201 S Maryland Pkwy Ste 608
Las Vegas, NV 89109-2428
Phone (702) 457-5437

Other practice location 1

880 Seven Hills Dr Ste 100
Henderson, NV 89052-4372
Phone (702) 457-5437

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201229001672 NV Practitioner - Pediatric Medicine 9436376563 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15854NVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1104113471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 S MARYLAND PKWY STE 608",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092428",
            "telephone_number": "702-457-5437",
            "fax_number": "702-464-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 S MARYLAND PKWY",
            "address_2": "STE 608",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092441",
            "telephone_number": "702-457-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "880 Seven Hills Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890524372",
            "country_code": "US",
            "telephone_number": "702-457-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CAROLINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "15854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.