Myranda Luong Guillen, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2799 Issued in NV

Practice address

1934 E Sahara Ave
Las Vegas, NV 89104-3842

Phone

(702) 369-5758

Fax

(702) 431-1860

NPI assigned

Mar 28, 2023

Last updated

Mar 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Women's Health Associates of Southern Nevada- Martin, PLLCGroup PAC ID 4082845664, 111 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Women's Health Associates of Southern Nevada- Martin, PLLC

  dba Women's Health Associates of Southern Nevada

  • Obstetrics & Gynecology Physician
  • Cleveland, OH
  • NPI 1598906166

  NV

  Medicare reassignment Care Compare group NPD
• Spring Valley Medical Center

  dba Valley Health Specialty Hospital

  • Rehabilitation Hospital Unit
  • Las Vegas, NV
  • NPI 1568439693
  NPD (past)

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1902500416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8906 SPANISH RIDGE AVE STE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481319",
            "telephone_number": "702-330-3102",
            "fax_number": "702-912-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 E SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891043842",
            "telephone_number": "702-369-5758",
            "fax_number": "702-431-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLEN",
        "first_name": "MYRANDA",
        "middle_name": "LUONG",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gilbert Guillen
• Gonzalo B Guillen III, APRN, AGPCNP
• Kris Marie Guillen, NP
• Liset Guillen
• Martin Guillen II
• Natalie Diane Guillen
• Naymy Guillen
• Patricia Guillen
• Sean Guillen, LICENSED OPTICIAN
• Victoria Guillen

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.