Miracle Wangsuwana, D.O.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

1253 Issued in NV

Practice address

6900 North Pecos Road
2ND Floor West Side 2B152 VA Southern Nevada
North Las Vegas, NV 89086

Phone

(702) 791-9161

Fax

(702) 671-5891

NPI assigned

Sep 26, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwangsuwana6309@direct.umcsn.com

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.

• Unlv Medicine

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1407397235
  Medicare reassignment NPD
• Sierra Neurology LLP

  • Medical Specialty Clinic/Center
  • Carson City, NV
  • NPI 1164599478
  NPD (past) Authorized official
• Unlv Medicine

  • Community/Retail Pharmacy
  • Las Vegas, NV
  • NPI 1184152274
  NPD
• Unlv Medicine

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1851811525
  NPD

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1750377693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 NORTH PECOS ROAD",
            "address_2": "2ND FLOOR WEST SIDE 2B 152 VA SOUTHERN NEVADA",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89086",
            "telephone_number": "702-791-9161",
            "fax_number": "702-895-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 NORTH PECOS ROAD",
            "address_2": "2ND FLOOR WEST SIDE 2B152 VA SOUTHERN NEVADA",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89086",
            "telephone_number": "702-791-9161",
            "fax_number": "702-671-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGSUWANA",
        "first_name": "MIRACLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2024-05-28",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NV",
            "license": "1253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100500484",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Wang
• Rui Wang
• Tien C Wang, M.D.
• Yao Wang, M.D.
• Jacob Wangerien
• Savanan Wara
• Brenda Ward
• Kenneth Ward
• Robert Ward III
• Theron Ward

• Neurology Physician in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Neurology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.