Individual provider Active NPI

Kirandeep Chahal, DO

  • Pediatrics Physician
  • Henderson, NV
National Provider Identifier
1487116117
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO3223 Issued in NV
Practice address
2350 W Horizon Ridge Pkwy
Henderson, NV 89052-5075
Phone
(702) 564-8556
Fax
(702) 564-4485
NPI assigned
Apr 2, 2019
Last updated
Nov 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DO3223 NV Primary

Addresses

Primary practice location

2350 W Horizon Ridge Pkwy
Henderson, NV 89052-5075

Mailing address

11315 Gravitation Dr
Las Vegas, NV 89135-3411
Phone (571) 527-9191

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
I20190830001706 NV Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 5991034886

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO3223NVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Hills Hospital Medical Center Past Accepting new patients

Organizations & group practices 1

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1487116117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11315 GRAVITATION DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891353411",
            "telephone_number": "571-527-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 W HORIZON RIDGE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525075",
            "telephone_number": "702-564-8556",
            "fax_number": "702-564-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAHAL",
        "first_name": "KIRANDEEP",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "DO3223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.