Individual provider Active NPI

Chamroen Eng, DO

  • Family Medicine Physician
  • Henderson, NV
National Provider Identifier
1114677309
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO3753 Issued in NV
Practice address
10624 S Eastern Ave # a-955
Henderson, NV 89052-2982
Phone
(702) 407-7700
NPI assigned
Mar 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO3753 NV Primary

Addresses

Primary practice location

10624 S Eastern Ave # a-955
Henderson, NV 89052-2982

Mailing address

10624 S Eastern Ave # a-955
Henderson, NV 89052-2982
Phone (702) 407-7700

Other identifiers 1

IdentifierTypeStateIssuer
1114677309MedicaidNV

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
I20241023003836 NV Practitioner - Family Practice 4880127281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platinum Hospitalists LLPGroup PAC ID 7214076322, 197 clinicians

Practice addresses (Care Compare)

7495 W Azure Dr
Suite 209
Las Vegas, NV 89130-4440
Phone (702) 407-7700

Hospital & facility affiliations

  • Summerlin Hospital Medical Center Hospital, Las Vegas, NV, CCN 290041
  • Centennial Hills Hospital Medical Center Hospital, Las Vegas, NV, CCN 290054
  • Spring Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290046
  • Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290021
  • Henderson Hospital Hospital, Henderson, NV, CCN 290057

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Platinum Hospitalists LLP Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Platinum Hospitalists LLP Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
Ucxtra Umbrella, LLC PastSince Dec 15, 2024 Accepting new patients

Locations

10624 S Eastern Ave
Ste A995
Henderson, NV 89052

10624 S Eastern Ave
#A955
Henderson, NV 89052
Phone (702) 407-7700

7495 W Azure Dr
Ste 209
Las Vegas, NV 89130
Phone (702) 327-6653

Organizations & group practices 4

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1114677309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE # A-955",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-407-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE # A-955",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-407-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENG",
        "first_name": "CHAMROEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO3753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114677309",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.