NPIMap

Organization Active NPI

Vkostanianmd PC

  • Vascular & Interventional Radiology Physician
  • Henderson, NV
National Provider Identifier
1679205405
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
VKOSTANIANMD PC
Practice address
10001 S Eastern Ave Ste 305
Henderson, NV 89052-3908
Phone
(702) 649-8009
Fax
(702) 201-1256
NPI assigned
Jun 29, 2022
Last updated
Nov 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Authorized official

Name
Varoujan KostanianNPI 1861417792
Title
Authorized Official/Owner
Phone
(702) 649-8009

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
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X Primary

Addresses

Primary practice location

10001 S Eastern Ave Ste 305
Henderson, NV 89052-3908

Mailing address

PO Box 370641
Las Vegas, NV 89137-0641
Phone (714) 609-9247

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220726003537 NV Part B Supplier - Clinic/Group Practice 8820470651 Receives reassigned benefits from 9 practitioners
Practice locations: Henderson, NV

National Provider Directory

National Provider Directory

Locations

3196 S Maryland Pkwy
Ste 202
Las Vegas, NV 89109
Phone (702) 369-4999

Practitioners & affiliated clinicians

Practitioners 10

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": "1656460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1679205405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370641",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891370641",
            "telephone_number": "714-609-9247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 S EASTERN AVE STE 305",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523908",
            "telephone_number": "702-649-8009",
            "fax_number": "702-201-1256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VKOSTANIANMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-29",
        "last_updated": "2023-11-22",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "KOSTANIAN",
        "authorized_official_first_name": "VAROUJAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/OWNER",
        "authorized_official_telephone_number": "702-649-8009"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; 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.