Organization Active NPI

Kan-Di-Ki, LLC

Doing business as Diagnostic Laboratories

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Las Vegas, NV
National Provider Identifier
1811210289
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
Legal business name
KAN-DI-KI, LLC
Doing business as
Diagnostic Laboratories
TridentCare
Practice address
7355 Prairie Falcon Rd
Las Vegas, NV 89128-0801
Phone
(702) 589-9795
Fax
(443) 842-7264
NPI assigned
Mar 12, 2010
Last updated
Mar 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Authorized official

Name
Brian C Cuomo
Title
Authorized Official/Cfo
Phone
(800) 786-8015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X NU Primary

Addresses

Primary practice location

7355 Prairie Falcon Rd
Las Vegas, NV 89128-0801

Mailing address

215 Schilling Cir Ste 114
Hunt Valley, MD 21031-1113
Phone (800) 786-8015

Other identifiers 2

IdentifierTypeStateIssuer
1811210289MedicaidNV
P00970024OtherNVRAILROAD MEDICARE

Other names 2

  • Diagnostic Laboratories Doing business as
  • TridentCare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100429000345 NV Part B Supplier - Portable X-Ray Supplier 5991737140 Receives reassigned benefits from 19 practitioners
Practice locations: Las Vegas, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811210289. Details of each certification follow.

Portable X-ray supplier certification: CCN 29X0009811

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
DIAGNOSTIC LABORATORIES PORTABLE X-RAY
Certification status
Active
Provider type (POS)
Portable X-ray supplier
Participating since
Oct 7, 2010
Last certification
May 24, 2016
Ownership / control type
Corporation
Facility address
7355 Prairie Falcon Road
Las Vegas, NV 89128

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Kan Di Ki LLC17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1811210289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SCHILLING CIR STE 114",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210311113",
            "telephone_number": "800-786-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7355 PRAIRIE FALCON RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280801",
            "telephone_number": "702-589-9795",
            "fax_number": "443-842-7264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAN-DI-KI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-12",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "CUOMO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/CFO",
        "authorized_official_telephone_number": "800-786-8015"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811210289",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00970024",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diagnostic Laboratories",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Diagnostic Laboratories",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TridentCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.