Organization Active NPI

Vip Surg (Tsuda Ryan), PLLC

  • Surgery Physician
  • Las Vegas, NV
National Provider Identifier
1306364914
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
VIP SURG (TSUDA RYAN), PLLC
Practice address
653 N Town Center Dr Ste 510
Las Vegas, NV 89144-0519
Phone
(702) 448-5578
Fax
(702) 703-2375
NPI assigned
Sep 3, 2017
Last updated
Nov 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Authorized official

Name
Dr. Shawn Tsuda, MDNPI 1407988389
Title
Owner
Phone
(702) 500-1646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

653 N Town Center Dr Ste 510
Las Vegas, NV 89144-0519

Mailing address

PO Box 34270
Las Vegas, NV 89133-4270
Phone (702) 500-1646

Other practice location 1

4275 Burnham Ave Ste 230
Las Vegas, NV 89119-5400
Phone (702) 448-5578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171213001425 NV Part B Supplier - Clinic/Group Practice 9739447186 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

3530 E Flamingo Rd
Ste 130
Las Vegas, NV 89121

3530 E Flamingo Rd
Ste 130A
Las Vegas, NV 89121
Phone (702) 487-6000

5950 S Durango Dr
Ste 105
Las Vegas, NV 89113
Phone (702) 487-6000

653 N Town Center Dr
Ste 510
Las Vegas, NV 89144
Phone (702) 448-5578

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1504396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1306364914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34270",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891334270",
            "telephone_number": "702-500-1646",
            "fax_number": "702-487-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR STE 510",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440519",
            "telephone_number": "702-448-5578",
            "fax_number": "702-703-2375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4275 Burnham Ave Ste 230",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891195400",
            "country_code": "US",
            "telephone_number": "702-448-5578",
            "fax_number": "702-703-2375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VIP SURG (TSUDA RYAN), PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-03",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "TSUDA",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-500-1646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.