Individual provider Active NPI

Mai T. Vuong, PA-C

  • Medical Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1811186646
Registry record updated Dec 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA933 Issued in NV
Practice address
4488 S Pecos Rd
Las Vegas, NV 89121-5030
Phone
(702) 462-7901
Fax
(760) 477-2929
NPI assigned
Oct 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA933 NV Primary

Addresses

Primary practice location

4488 S Pecos Rd
Las Vegas, NV 89121-5030

Mailing address

4488 S Pecos Rd
Las Vegas, NV 89121
Phone (702) 462-7901

Other identifiers 1

IdentifierTypeStateIssuer
P01041225OtherNVRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA933NVMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1811186646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4488 S PECOS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89121",
            "telephone_number": "702-462-7901",
            "fax_number": "760-477-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4488 S PECOS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215030",
            "telephone_number": "702-462-7901",
            "fax_number": "760-477-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUONG",
        "first_name": "MAI",
        "middle_name": "T.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01041225",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.