Individual provider Active NPI

Timothy Lo

  • Student in an Organized Health Care Education/Training Program
  • Las Vegas, NV
National Provider Identifier
1396372520
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1701 W Charleston Blvd Ste 230
Las Vegas, NV 89102-2312
Phone
(702) 671-2329
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Internal Medicine Physician 207R00000X 34.016602 OH

Addresses

Primary practice location

1701 W Charleston Blvd Ste 230
Las Vegas, NV 89102-2312

Mailing address

1701 W Charleston Blvd Ste 230
Las Vegas, NV 89102-2312
Phone (702) 671-2329

Other practice location 1

128 E Apple St Fl 2
Dayton, OH 45409-2902
Phone (937) 208-2004

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
I20250821001968 NV Order and Referring Only - Pulmonary DiseasePractitioner - Pulmonary Disease 7618398330

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.17 of 100Reported as group
Quality
65.6
Promoting interoperability
100
Improvement activities
40
Cost
74.7

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
73.78

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1396372520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD STE 230",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022312",
            "telephone_number": "702-671-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD STE 230",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022312",
            "telephone_number": "702-671-2329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 E Apple St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092902",
            "country_code": "US",
            "telephone_number": "937-208-2004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LO",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.016602",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.