NPIMap

Individual provider Active NPI

Terrance J Kwiatkowski, MD

  • Otology & Neurotology Physician
  • Henderson, NV
National Provider Identifier
1659353753
Registry record updated Mar 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otology & Neurotology PhysicianTaxonomy code 207YX0901X
License
9962 Issued in NV
Practice address
10410 S Eastern Ave Ste 110
Henderson, NV 89052-4196
Phone
(702) 966-3100
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 9962 NV
Audiologist 231H00000X
Otology & Neurotology Physician 207YX0901X 9962 NV Primary

Addresses

Primary practice location

10410 S Eastern Ave Ste 110
Henderson, NV 89052-4196

Mailing address

PO Box 530521
Henderson, NV 89053-0521
Phone (702) 966-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040818001140 NV Practitioner - OtolaryngologyPractitioner - Other (Physician) 6608866827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10410 S Eastern Ave
Suite 110
Henderson, NV 89052-4196
Phone (702) 966-3100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9962NVMDOtology & Neurotology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Terrance Kwiatkowski, Professional Corporation Otolaryngology CurrentSince Dec 1, 2003 Accepting new patients
Kwiatkowski Surgical PLLC Current Accepting new patients
Bullhead City Clinic Corp Family Medicine Past Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients
Kwiatkowski MD PLLC Otolaryngology Past Accepting new patients
Scripps Health Past Accepting new patients
Regents of the University of California Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Bullhead City Clinic Corp Family Medicine PastSince Apr 1, 2009 Accepting new patients

Locations

10410 S Eastern Ave
Ste 110
Henderson, NV 89052
Phone (702) 966-3100

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

8530 W Sunset Rd
Ste 240
Las Vegas, NV 89113
Phone (702) 796-0022

653 N Town Center Dr
Ste 602
Las Vegas, NV 89144
Phone (702) 888-1188

Interoperability endpoints

  • Direct secure messaging: terrance.kwiatkowski@dk-nv.direct.office.nextgen.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FBCIDD/Endpoint/FBCIDD
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 9

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 2

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741996800000",
    "number": "1659353753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530521",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890530521",
            "telephone_number": "702-966-3100",
            "fax_number": "702-966-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10410 S EASTERN AVE STE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524196",
            "telephone_number": "702-966-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWIATKOWSKI",
        "first_name": "TERRANCE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2025-03-15",
        "certification_date": "2025-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NV",
            "license": "9962",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "NV",
            "license": "9962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.