Active NPI
Kimchi Nguyen, PA-C
- Physician Assistant
- Henderson, NV
National Provider Identifier
1215435573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2419
- Practice address
- 2310 Corporate Cir
Ste 200
Henderson, NV 89074 - Phone
- (702) 735-8000
- Fax
- (702) 563-2937
- NPI assigned
- Jan 31, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 55298 | CA | |
| Physician Assistant | 363A00000X | PA2419 | NV | Primary |
Addresses
Primary practice location
2310 Corporate Cir
Ste 200
Henderson, NV 89074
Mailing address
7500 Smoke Ranch Road
Ste 200
Las Vegas, NV 89128-0373
Phone (702) 233-0727
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220829002211 | NV | Practitioner - Physician Assistant | 0244614089 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Apex Medical CenterLas Vegas Urology LLP
Practice addresses (Care Compare)
1701 Wellness Way
Suite 200
Las Vegas, NV 89106-4146
Phone (702) 310-9110
2310 Corporate Cir
Suite 200
Henderson, NV 89074-7729
Phone (702) 735-8000
7150 W Sunset Rd
Las Vegas, NV 89113-1982
Merit-based Incentive Payment System (MIPS)
- Final score
- 65.83 of 100
- Quality
- 53.92
- Improvement activities
- 20
- Cost
- 70.7
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55298 | CA | MD | General Practice Dentistry |
| PA2419 | NV | MD | Physician Assistant |
Interoperability endpoints
- kimchinguyen@lvu.medalliesdirect.net
- kimchi@amc-nv1.direct.office.nextgen.com
Organizations & group practices 2
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": "1517356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771891200000",
"number": "1215435573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7500 SMOKE RANCH ROAD",
"address_2": "STE 200",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891280373",
"telephone_number": "702-233-0727",
"fax_number": "702-233-4799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 CORPORATE CIR",
"address_2": "STE 200",
"city": "HENDERSON",
"state": "NV",
"postal_code": "89074",
"telephone_number": "702-735-8000",
"fax_number": "702-563-2937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KIMCHI",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-31",
"last_updated": "2026-02-24",
"certification_date": "2026-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "55298",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "NV",
"license": "PA2419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.