Individual provider Active NPI

Kimchi Nguyen, PA-C

  • Physician Assistant
  • Henderson, NV
National Provider Identifier
1215435573
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2419 Issued in NV
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

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 55298 CA
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Center 12 clinicians
Las Vegas Urology LLP 51 clinicians

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 100Reported as group
Quality
53.92
Improvement activities
20
Cost
70.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
55298CAMDGeneral Practice Dentistry
PA2419NVMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: kimchinguyen@lvu.medalliesdirect.net
  • Direct secure messaging: 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

Verify at the official NPI Registry.