Individual provider Active NPI

Johnny Mirador Chua Jr., NURSE PRACTITIONER

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1891269734
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
817423 Issued in NV
Practice address
3150 N Tenaya Way Ste 260
Las Vegas, NV 89128-0459
Phone
(702) 962-5920
NPI assigned
Jan 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 817423 NV
Nurse Practitioner 363L00000X 817423 NV Primary

Addresses

Primary practice location

3150 N Tenaya Way Ste 260
Las Vegas, NV 89128-0459

Mailing address

3150 N Tenaya Way Ste 260
Las Vegas, NV 89128-0459
Phone (702) 962-5920

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190422001532 NV Practitioner - Nurse Practitioner 5496097552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunrise Mountainview Multispecialty Clinics LLCGroup PAC ID 1759469711, 64 clinicians

Practice addresses (Care Compare)

3150 N Tenaya Way
Suite 260
Las Vegas, NV 89128-0459
Phone (702) 962-5920

4270 S Decatur Blvd
Suite A1 Ab
Las Vegas, NV 89103-6802
Phone (725) 529-2482

Hospital & facility affiliations

  • Reliant Home Health Care LLC Home health agency, Las Vegas, NV, CCN 297357
  • Mountainview Hospital Hospital, Las Vegas, NV, CCN 290039
  • Southern Hills Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
817423NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Mountainview Multispecialty Clinics, LLC CurrentSince Dec 27, 2021 Accepting new patients
Charleston Chua MD Medical Spa PLLC CurrentSince Nov 29, 2024 Accepting new patients
Desert Springs Hospital Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

4270 S Decatur Blvd
Ste A1
Las Vegas, NV 89103
Phone (702) 988-8800

3150 N Tenaya Way
Ste 260
Las Vegas, NV 89128
Phone (702) 870-2099

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: johnny.chua@hca3.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1891269734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 N TENAYA WAY STE 260",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280459",
            "telephone_number": "702-962-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N TENAYA WAY STE 260",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280459",
            "telephone_number": "702-962-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUA",
        "first_name": "JOHNNY",
        "middle_name": "MIRADOR",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-14",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NV",
            "license": "817423",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "817423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.