Individual provider Active NPI

Tsung Han Stan Liu, M.D.

  • Vascular & Interventional Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1619914769
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
7809 Issued in NV
Practice address
5495 S Rainbow Blvd Ste 101
Las Vegas, NV 89118-1872
Phone
(702) 477-0772
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 7809 NV
Vascular & Interventional Radiology Physician 2085R0204X 7809 NV Primary

Addresses

Primary practice location

5495 S Rainbow Blvd Ste 101
Las Vegas, NV 89118-1872

Mailing address

PO Box 30077
Dept 305
Salt Lake City, UT 84130-0077
Phone (877) 243-8416

Other identifiers 5

IdentifierTypeStateIssuer
153095OtherNVWC
200290106MedicaidNV
153079OtherNVWC
NV7390OtherNVBCBS
NV8666OtherNVBCBS

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
I20040412001756 NV Practitioner - Interventional RadiologyPractitioner - Nuclear Medicine 3476547415 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7809NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
J Paul Wiesner & Associates Chartered Diagnostic Radiology CurrentSince Jun 11, 1996 Accepting new patients
Pueblo Medical Imaging, LLC Diagnostic Radiology CurrentSince Feb 15, 2012 Accepting new patients

Locations

102 E Lake Mead Pkwy
Henderson, NV 89015
Phone (701) 564-2622

100 N Green Valley Pkwy
Ste 130
Henderson, NV 89074
Phone (702) 990-7417

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

800 Shadow Ln
Las Vegas, NV 89106
Phone (702) 366-9700

8551 W Lake Mead Blvd
Ste 150
Las Vegas, NV 89128
Phone (702) 683-5516

2628 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 644-0500

600 S Rancho Dr
Ste 102
Las Vegas, NV 89106
Phone (702) 255-8785

5495 S Rainbow Blvd
Ste 101
Las Vegas, NV 89118
Phone (702) 214-9729

5495 S Rainbow Blvd
Ste 203
Las Vegas, NV 89118

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1619914769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30077",
            "address_2": "DEPT 305",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300077",
            "telephone_number": "877-243-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5495 S RAINBOW BLVD STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181872",
            "telephone_number": "702-477-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "TSUNG HAN",
        "middle_name": "STAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "7809",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NV",
            "license": "7809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WC",
            "identifier": "153095",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200290106",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WC",
            "identifier": "153079",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NV7390",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NV8666",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.