Jesse Ang, M.D.
Individual provider Active NPI Pediatrics Physician · Las Vegas, NV
NPI 1891863718 · NPPES record last updated Jan 7, 2014
Key facts
- NPI
- 1891863718
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 11512 (NV)
- Practice address
- 2212 S Eastern Ave
Las Vegas, NV 89104-4124 - Phone
- (702) 735-9334
- Fax
- (702) 735-9335
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101206001230 | NV | Practitioner - Pediatric Medicine | 7315134145 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nevada Health Centers, Inc | Current |
Accepting new patients | |
| Nevada Health Centers, Inc | Current |
Accepting new patients |
Locations
1690 E Amargosa Farm Rd
Amargosa Valley, NV 89020
Phone (775) 372-5432
3325 Research Way
Carson City, NV 89706
Phone (775) 887-5140
618 W Musser St
Carson City, NV 89703
Phone (775) 445-3500
762 14th St
Elko, NV 89801
Phone (775) 738-5850
2212 S Eastern Ave
Las Vegas, NV 89104
Phone (702) 220-9908
3900 Cambridge St
Ste 102
Las Vegas, NV 89119
Phone (702) 307-5415
Interoperability endpoints
- jessea@direct.nevadahealthcenters.nextgenshare.com
- jang694813@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 11512 | NV | Yes |
Addresses
Primary practice location
2212 S Eastern Ave
Las Vegas, NV 89104-4124
Mailing address
3325 Research Way
Carson City, NV 89706-7913
Phone (775) 888-6610
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11512 | Other | NV | MEDICAL LICENSE |
| 1891863718 | Medicaid | NV |
Other providers in Las Vegas, NV
- Sara Aneyan
- Ang Medical Supplies LLC
- Beatriz Ang-Ermocilla
- Almira Ang
- Earl Robert G Ang
- Dayami Angarica
- Yanet Angarica
- Lina Angarita
- Anna-Lizette Matias Angat
- Bernadette Angat
All providers in Las Vegas, NV · Pediatrics Physician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.