NPIMap

Individual provider Active NPI

Sisi Tian, M.D.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Las Vegas, NV
National Provider Identifier
1447510854
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
17068 Issued in NV
Practice address
5320 S Rainbow Blvd Ste 250
Las Vegas, NV 89118-1807
Phone
(702) 671-6480
Fax
(702) 671-6481
NPI assigned
May 18, 2012
Last updated
Oct 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology Physician 207Y00000X 17068 NV
Otolaryngology Physician 207Y00000X A126477 CA
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 17068 NV Primary

Addresses

Primary practice location

5320 S Rainbow Blvd Ste 250
Las Vegas, NV 89118-1807

Mailing address

3016 W Charleston Blvd Ste 100
Las Vegas, NV 89102-1973
Phone (702) 780-2315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170628002824 NV Practitioner - Otolaryngology 4880963222 Reassigns benefits to 1 organization
I20200902000392 CA Practitioner - Otolaryngology 4880963222 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Loma Linda University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Practice addresses (Care Compare)

1707 W Charleston Blvd
Suite 230
Las Vegas, NV 89102-2353
Phone (702) 671-6412

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A126477CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System Current Accepting new patients
Unlv Medicine CurrentSince Sep 25, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Unlv Medicine Current Accepting new patients
Beaver Medical Group P C CurrentSince Mar 1, 2023 Accepting new patients
Sac Health System Otolaryngology CurrentSince Sep 1, 2020 Accepting new patients
Unlv Medicine CurrentSince Sep 25, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 1, 2020 Accepting new patients
Beaver Medical Group P C CurrentSince Mar 1, 2023 Accepting new patients
Sac Health System Otolaryngology CurrentSince Sep 1, 2020 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 1, 2020 Accepting new patients
Desert Springs Hospital Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Beaver Medical Group P C Past Accepting new patients
Loma Linda University Children's Hospital Past Accepting new patients
Physicians' Hospital of Murrieta, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11234 Anderson St
Ofc Csp
Loma Linda, CA 92350
Phone (909) 558-4015

11234 Anderson St
Rm 2586A
Loma Linda, CA 92350
Phone (909) 558-7884

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste 2100
Loma Linda, CA 92354
Phone (909) 558-2600

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700

28078 Baxter Rd
Murrieta, CA 92563
Phone (760) 533-4541

2 W Fern Ave
Redlands, CA 92373
Phone (909) 786-0725

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

44274 George Cushman Ct
Ste 208
Temecula, CA 92592
Phone (951) 501-4200

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

1707 W Charleston Blvd
Ste 230
Las Vegas, NV 89102
Phone (702) 671-5060

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

3016 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 780-2315

5320 S Rainbow Blvd
Ste 250
Las Vegas, NV 89118
Phone (702) 671-6480

Interoperability endpoints

  • Direct secure messaging: stian122400@direct.umcsn.com
  • Direct secure messaging: stian22452@epiclp.direct-ci.com

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 12

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": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1447510854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021973",
            "telephone_number": "702-780-2315",
            "fax_number": "702-895-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 S RAINBOW BLVD STE 250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181807",
            "telephone_number": "702-671-6480",
            "fax_number": "702-671-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIAN",
        "first_name": "SISI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-18",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NV",
            "license": "17068",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A126477",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NV",
            "license": "17068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.