NPIMap

Individual provider Active NPI

Chaorui Tian, M.D., PH.D.

  • Gastroenterology Physician
  • Las Vegas, NV
National Provider Identifier
1801057625
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
15649 Issued in NV
Practice address
2316 W Charleston Blvd
Las Vegas, NV 89102-2149
Phone
(702) 877-8330
Fax
(702) 870-9876
NPI assigned
Jun 24, 2008
Last updated
Aug 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 15649 NV Primary

Addresses

Primary practice location

2316 W Charleston Blvd
Las Vegas, NV 89102-2149

Mailing address

PO Box 15645
Las Vegas, NV 89114-5645
Phone (702) 579-3272

Other identifiers 1

IdentifierTypeStateIssuer
1801057625MedicaidNV

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
I20150605002371 NV Practitioner - GastroenterologyPractitioner - Internal Medicine 1052632734 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

4750 W Oakey Blvd
Las Vegas, NV 89102-1535
Phone (702) 579-3253

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy40
Upper gastrointestinal (GI) endoscopy for acid reflux28

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, Inc CurrentSince Jul 13, 2015 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Jun 1, 2019 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Jun 1, 2019 Accepting new patients
Desert Springs Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

2316 W Charleston Blvd
Ste 274
Las Vegas, NV 89102

2704 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 243-8500

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

4750 W Oakey Blvd
Ste 3B
Las Vegas, NV 89102

Interoperability endpoints

  • Direct secure messaging: ctian119235@westdirect.optum.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1801057625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "702-579-3272",
            "fax_number": "702-667-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2316 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022149",
            "telephone_number": "702-877-8330",
            "fax_number": "702-870-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIAN",
        "first_name": "CHAORUI",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NV",
            "license": "15649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801057625",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.