Individual provider Active NPI

Rong Fan, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Las Vegas, NV
National Provider Identifier
1669648408
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
27457 Issued in NV
Practice address
7455 W Washington Ave Ste 301
Las Vegas, NV 89128-4340
Phone
(702) 732-3441
NPI assigned
May 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01065131A IN
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301510501 MI
Pediatric Pathology Physician 207ZP0213X 313196-01 NY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 27457 NV Primary

Addresses

Primary practice location

7455 W Washington Ave Ste 301
Las Vegas, NV 89128-4340

Mailing address

1355 River Bend Dr
Dallas, TX 75247-4915
Phone (027) 732-3441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, NJ, MI, NV, AZ, TX6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20080619000673 IN Practitioner - Pathology 7517038474 Reassigns benefits to 1 organization
I20200818003678 NJ Practitioner - Pathology 7517038474
I20240224000061 MI Practitioner - Pathology 7517038474 Reassigns benefits to 1 organization
I20250625001153 NV Practitioner - Pathology 7517038474 Reassigns benefits to 1 organization
I20250924002894 AZ Practitioner - Pathology 7517038474 Reassigns benefits to 1 organization
I20260305001224 TX Practitioner - Pathology 7517038474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7455 W Washington Ave
Las Vegas, NV 89128-4337
Phone (702) 732-3441

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
85.06
Promoting interoperability
100
Improvement activities
40
Cost
77.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
313196-01NYMDPediatric Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. CurrentSince Apr 1, 2016 Accepting new patients
Laboratory Medicine Consultants LTD Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2025 Accepting new patients
Austin Pathology Associates Anatomic Pathology & Clinical Pathology CurrentSince Dec 30, 2025 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince Feb 29, 2024 Accepting new patients
University Family Physicians, Inc. CurrentSince Apr 1, 2016 Accepting new patients
Laboratory Medicine Consultants LTD CurrentSince Aug 1, 2025 Accepting new patients

Locations

5330 S Highway 95
Fort Mohave, AZ 86426
Phone (928) 788-2273

File 749203
Los Angeles, CA 90074

7216 Solutions Ctr
Chicago, IL 60677

350 W 11th St
Rm 6016
Indianapolis, IN 46202
Phone (317) 491-6000

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

3601 W 13 Mile Rd
Royal Oak, MI 48073

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

3059 S Maryland Pkwy
Ste 100
Las Vegas, NV 89109
Phone (702) 732-3441

7455 W Washington Ave
Las Vegas, NV 89128
Phone (702) 449-4192

7455 W Washington Ave
Ste 301
Las Vegas, NV 89128
Phone (702) 732-3441

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

12221 N Mopac Expy
Fl 4
Austin, TX 78758
Phone (512) 901-1215

3801 N Lamar Blvd
Austin, TX 78756
Phone (512) 407-7000

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

1355 River Bend Dr
Dallas, TX 75247
Phone (214) 237-1818

2001 N Oregon St
El Paso, TX 79902
Phone (915) 577-6011

3280 Joe Battle Blvd
El Paso, TX 79938
Phone (915) 577-6000

1625 Medical Center Dr
El Paso, TX 79902
Phone (915) 577-7746

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1669648408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 RIVER BEND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474915",
            "telephone_number": "027-732-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7455 W WASHINGTON AVE STE 301",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891284340",
            "telephone_number": "702-732-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "RONG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-01",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01065131A",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301510501",
            "primary": false
        },
        {
            "code": "207ZP0213X",
            "taxonomy_group": "",
            "desc": "Pathology, Pediatric Pathology",
            "state": "NY",
            "license": "313196-01",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NV",
            "license": "27457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.