Individual provider Active NPI

Shawn T Tsuda, M.D.

  • Surgery Physician
  • Las Vegas, NV
National Provider Identifier
1407988389
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
12532 Issued in NV
Practice address
653 N Town Center Dr Ste 510
Las Vegas, NV 89144-0519
Phone
(702) 448-5578
Fax
(702) 703-2375
NPI assigned
Mar 9, 2007
Last updated
Nov 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 12532 NV 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081106000208 NV Practitioner - General Surgery 3173682119 Reassigns benefits to 1 organization
I20240206004199 AZ Practitioner - General Surgery 3173682119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Hawaii John a. Burns School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kingman Healthcare IncGroup PAC ID 6901791367, 185 clinicians

Practice addresses (Care Compare)

3104 N Stockton Hill Rd
Kingman, AZ 86401-4183
Phone (928) 681-8720

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.85 of 100Reported as group
Quality
84.49
Promoting interoperability
83
Improvement activities
40
Cost
79.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux12
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kingman Healthcare, Inc Current Accepting new patients
Vip Surg (Tsuda Ryan), PLLC Surgery CurrentSince Apr 21, 2018 Accepting new patients
Kingman Healthcare, Inc Surgery CurrentSince Feb 1, 2024 Accepting new patients
Kingman Healthcare, Inc CurrentSince Feb 1, 2024 Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Advanced Paincare LLP PastSince Apr 1, 2020 Accepting new patients
North Vista Hospital LLC Past Accepting new patients

Locations

3104 N Stockton Hill Rd
Kingman, AZ 86401
Phone (928) 681-8720

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

3530 E Flamingo Rd
Ste 130
Las Vegas, NV 89121

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

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

Interoperability endpoints

  • Direct secure messaging: tsuda.shawn@direct.azkrmc.md

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1407988389",
    "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": [],
    "basic": {
        "last_name": "TSUDA",
        "first_name": "SHAWN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "12532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.