NPIMap

Individual provider Active NPI

Edward Charles Van Vooren, D.O.

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1770512477
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1278 Issued in NV
Practice address
2020 Palomino Lane
Suite 100
Las Vegas, NV 89106-4894
Phone
(702) 759-8600
Fax
(702) 384-1518
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0215 ID
Diagnostic Radiology Physician 2085R0202X 1278 NV Primary

Addresses

Primary practice location

2020 Palomino Lane
Suite 100
Las Vegas, NV 89106-4894

Mailing address

2020 Palomino Lane
Suite 100
Las Vegas, NV 89106-4894
Phone (702) 759-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, ID, CO3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20060913000055 NV Practitioner - Diagnostic Radiology 5890799431 Reassigns benefits to 7 organizations
I20101026000541 ID Practitioner - Diagnostic Radiology 5890799431 Reassigns benefits to 5 organizations
I20250121001216 CO Practitioner - Diagnostic Radiology 5890799431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shelin Agrawal and Hyer PLLCGroup PAC ID 5890955959, 65 clinicians
Teton Radiology Madison LLCGroup PAC ID 6901958024, 40 clinicians
Yampa Valley Medical CenterGroup PAC ID 5890685689, 128 clinicians
Ellis Bandt Birkin Kollins and Wong PLLCGroup PAC ID 4486568946, 68 clinicians

Practice addresses (Care Compare)

Sandpoint, ID 83864
Phone (702) 759-8600

Las Vegas, NV 89101
Phone (208) 356-4888

Las Vegas, NV 89106
Phone (702) 759-8600

1024 Central Park Dr
Steamboat SPR, CO 80487-8813
Phone (970) 879-1322

200 Hoover Ave
Unit 1801
Las Vegas, NV 89101-6884
Phone (208) 522-3017

2020 Palomino LN
Suite 100
Las Vegas, NV 89106-4894
Phone (702) 759-8600

4000 E Sky Harbor Dr
Coeur D Alene, ID 83814-7537
Phone (702) 759-8600

573 Cutter LN
Sandpoint, ID 83864-1967
Phone (208) 522-3017

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0215IDMDDiagnostic Radiology Physician
1278NVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Bandt Birkin Kollins & Wong PLLC Diagnostic Radiology CurrentSince Sep 8, 2015 Accepting new patients
Teton Radiology Madison LLC CurrentSince Jan 1, 2026 Accepting new patients
Yampa Valley Medical Center Current Accepting new patients
Shelin Agrawal and Hyer PLLC Diagnostic Radiology CurrentSince Sep 8, 2015 Accepting new patients
Teton Radiology Caldwell Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Yampa Valley Medical Center CurrentSince Nov 14, 2024 Accepting new patients
Teton Radiology Diagnostic a Series of Teton Group Enterprise Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Yampa Valley Medical Center CurrentSince Nov 14, 2024 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Aug 14, 2019 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Aug 14, 2019 Accepting new patients
California Advanced Imaging Medical Associates Inc Diagnostic Radiology Past Accepting new patients
Medical Imaging Associates of Idaho Falls, Inc Diagnostic Radiology Past Accepting new patients

Locations

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1024 Central Park Dr
Steamboat Springs, CO 80487
Phone (970) 824-1322

4519 Enterprise Way
Caldwell, ID 83605
Phone (208) 454-4960

2001 S Woodruff Ave
Ste 17
Idaho Falls, ID 83404
Phone (208) 524-7237

425 E 4th N
Rexburg, ID 83440

2811 W Horizon Ridge Pkwy
Henderson, NV 89052

1050 W Galleria Dr
Henderson, NV 89011
Phone (702) 723-4124

3175 Saint Rose Pkwy
Ste 130
Henderson, NV 89052
Phone (702) 932-2740

3920 S Eastern Ave
Ste 100
Las Vegas, NV 89119
Phone (702) 759-8779

888 S Rancho Dr
Las Vegas, NV 89106
Phone (702) 877-5375

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

31 N Nellis Blvd
Las Vegas, NV 89110

2020 Palomino Ln
Ste 100
Las Vegas, NV 89106
Phone (702) 759-8779

4880 Wynn Rd
Ste 100
Las Vegas, NV 89103
Phone (702) 759-4600

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

7200 Cathedral Rock Dr
Ste 230
Las Vegas, NV 89128
Phone (702) 623-7568

3025 S Rainbow Blvd
Las Vegas, NV 89146
Phone (702) 222-2354

1397 S Loop Rd
Ste 100
Pahrump, NV 89048

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1770512477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LANE",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LANE",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600",
            "fax_number": "702-384-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN VOOREN",
        "first_name": "EDWARD",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "0215",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "1278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.