NPIMap

Organization Active NPI

Jae Choi MD PLLC

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1649638438
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
JAE CHOI MD PLLC
Practice address
70 Pristine Glen St
Las Vegas, NV 89135-7891
Phone
(702) 904-0242
NPI assigned
Feb 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Authorized official

Name
Jae Choi, MDNPI 1689660672
Title
Member
Phone
(702) 904-0242

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

70 Pristine Glen St
Las Vegas, NV 89135-7891

Mailing address

70 Pristine Glen St
Las Vegas, NV 89135-7891

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160308001222 NV Part B Supplier - Clinic/Group Practice 1658677232 Receives reassigned benefits from 7 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

11700 W Charleston Blvd
Ste 17
Las Vegas, NV 89135

11700 W Charleston Blvd
Ste 170478
Las Vegas, NV 89135

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454889600000",
    "number": "1649638438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 PRISTINE GLEN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891357891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PRISTINE GLEN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891357891",
            "telephone_number": "702-904-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAE CHOI MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-08",
        "last_updated": "2016-02-08",
        "status": "A",
        "authorized_official_last_name": "CHOI",
        "authorized_official_first_name": "JAE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "702-904-0242",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 8, 2016; 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.