Organization Active NPI

Thomas T Chen, MD, LTD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1639344575
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8155 Issued in NV
Legal business name
THOMAS T CHEN, MD, LTD
Practice address
653 N Town Center Dr
Suite 300
Las Vegas, NV 89144-0514
Phone
(702) 456-7255
Fax
(702) 456-7855
NPI assigned
Apr 22, 2008
Last updated
Apr 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Miss Beverly Ann Roderick
Title
Practice Manager
Phone
(702) 456-7255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8155 NV Primary

Addresses

Primary practice location

653 N Town Center Dr
Suite 300
Las Vegas, NV 89144-0514

Mailing address

PO Box 370908
Las Vegas, NV 89137-0908
Phone (702) 456-7255

Other identifiers 2

IdentifierTypeStateIssuer
003102382MedicaidNV
002018182MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090817000412 NV Part B Supplier - Clinic/Group Practice 0345269445 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

653 N Town Center Dr
Ste 404
Las Vegas, NV 89144
Phone (702) 454-0014

653 N Town Center Dr
Ste 500
Las Vegas, NV 89144
Phone (702) 240-2200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1639344575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370908",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891370908",
            "telephone_number": "702-456-7255",
            "fax_number": "702-456-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR",
            "address_2": "SUITE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440514",
            "telephone_number": "702-456-7255",
            "fax_number": "702-456-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS T CHEN, MD, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "RODERICK",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "702-456-7255",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "8155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003102382",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018182",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.