Individual provider Active NPI

Janie Kwak-Tran, M.D.

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1497847438
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10236 Issued in NV
Practice address
5052 S Jones Blvd Ste 105
Las Vegas, NV 89118-0552
Phone
(702) 220-9611
Fax
(702) 220-9163
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10236 NV Primary

Addresses

Primary practice location

5052 S Jones Blvd Ste 105
Las Vegas, NV 89118-0552

Mailing address

10624 S Eastern Ave # A285
Henderson, NV 89052-2982
Phone (702) 220-9611

Other identifiers 6

IdentifierTypeStateIssuer
861057211OtherNVTRICARE
861057211OtherNVCIGNA
861057211OtherNVAETNA
002018869MedicaidNV
10236OtherNVNV STATE LICENSE
861057211OtherNVBCBS

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
I20031210000187 NV Practitioner - Internal Medicine 1759287816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Nevada School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5052 S Jones Blvd
Suite 105
Las Vegas, NV 89118-0552
Phone (702) 220-9611

Hospital & facility affiliations

  • Fidelity Home Health Services, LLC Home health agency, Las Vegas, NV, CCN 297217

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Janie Kwak Tran MD Inc Internal Medicine CurrentSince Nov 1, 2002 Accepting new patients

Locations

10624 S Eastern Ave
#A285
Henderson, NV 89052

5052 S Jones Blvd
Ste 105
Las Vegas, NV 89118
Phone (702) 220-9611

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGIGBD/Endpoint/DGIGBD

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1497847438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE # A285",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-220-9611",
            "fax_number": "702-220-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5052 S JONES BLVD STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891180552",
            "telephone_number": "702-220-9611",
            "fax_number": "702-220-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAK-TRAN",
        "first_name": "JANIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "10236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "861057211",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "861057211",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "861057211",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018869",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV STATE LICENSE",
            "identifier": "10236",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "861057211",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.