Individual provider Active NPI

William Vu Quach, DO

  • Pediatrics Physician
  • Henderson, NV
National Provider Identifier
1477012276
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO3185 Issued in NV
Practice address
871 Coronado Center Dr Ste 141
Henderson, NV 89052-3977
Phone
(702) 566-2400
Fax
(702) 735-2296
NPI assigned
Mar 19, 2019
Last updated
Jul 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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 NU
Pediatrics Physician 208000000X DO3185 NV Primary

Addresses

Primary practice location

871 Coronado Center Dr Ste 141
Henderson, NV 89052-3977

Mailing address

871 Coronado Center Dr Ste 141
Henderson, NV 89052-3977
Phone (702) 566-2400

Other practice location 1

1524 Pinto Ln Fl 2
Las Vegas, NV 89106-4195
Phone (702) 780-7587

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
I20250224003221 NV Practitioner - Pediatric Medicine 1951630649 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO3185NVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine CurrentSince Feb 3, 2025 Accepting new patients
Unlv Medicine Current Accepting new patients
Unlv Medicine CurrentSince Feb 3, 2025 Accepting new patients
Henderson Hospital Past Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients

Locations

1524 Pinto Ln
Fl 2
Las Vegas, NV 89106
Phone (702) 671-2236

1524 Pinto Ln
Fl 3
Las Vegas, NV 89106
Phone (702) 944-2828

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

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1477012276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 CORONADO CENTER DR STE 141",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523977",
            "telephone_number": "702-566-2400",
            "fax_number": "702-735-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 CORONADO CENTER DR STE 141",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523977",
            "telephone_number": "702-566-2400",
            "fax_number": "702-735-2296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1524 Pinto Ln Fl 2",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891064195",
            "country_code": "US",
            "telephone_number": "702-780-7587",
            "fax_number": "702-671-2223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUACH",
        "first_name": "WILLIAM",
        "middle_name": "VU",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "DO3185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.