NPIMap

Individual provider Active NPI

Johnson Ukken, MD

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1932763737
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22377 Issued in NV
Practice address
1524 Pinto LN FL 2
Las Vegas, NV 89106-4195
Phone
(702) 992-6888
NPI assigned
Apr 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 22377 NV Primary

Addresses

Primary practice location

1524 Pinto LN FL 2
Las Vegas, NV 89106-4195

Mailing address

1701 W Charleston Blvd Ste 590
Las Vegas, NV 89102-2396
Phone (702) 992-6875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230223001397 NV Practitioner - Family Practice 1456688829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Practice addresses (Care Compare)

1524 Pinto LN
FL 3
Las Vegas, NV 89106-4195
Phone (702) 944-2828

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22377NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine CurrentSince Nov 1, 2022 Accepting new patients
Unlv Medicine Current Accepting new patients
Unlv Medicine CurrentSince Nov 1, 2022 Accepting new patients
Desert Springs Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients

Locations

2724 N Tenaya Way
#2
Las Vegas, NV 89128

1524 Pinto Ln
Fl 2
Las Vegas, NV 89106
Phone (702) 671-2236

3016 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 780-2315

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

1524 Pinto Ln
Fl 3
Las Vegas, NV 89106
Phone (702) 944-2828

1701 W Charleston Blvd
Ste 590
Las Vegas, NV 89102
Phone (702) 992-6875

2724 N Tenaya Way
Fl 2
Las Vegas, NV 89128
Phone (702) 939-8557

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

Organizations & group practices 8

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 12

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": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1932763737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD STE 590",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022396",
            "telephone_number": "702-992-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 PINTO LN FL 2",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064195",
            "telephone_number": "702-992-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKKEN",
        "first_name": "JOHNSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-26",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "22377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.