Individual provider Active NPI

Josephine Sun

  • Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1992209316
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
LL3176NV Issued in NV
Practice address
1524 Pinto LN FL 3
Las Vegas, NV 89106-4195
Phone
(702) 944-2828
Fax
(702) 944-2852
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X LL3176NV NV Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1524 Pinto LN FL 3
Las Vegas, NV 89106-4195

Mailing address

3016 W Charleston Blvd Ste 100
Las Vegas, NV 89102-1973
Phone (702) 780-2311

Other practice location 1

1524 Pinto Ln Fl 2
Las Vegas, NV 89106-4195
Phone (702) 671-2236

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210824003524 NV Practitioner - Pediatric Medicine 9436407905 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL3176NVNVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine Current Accepting new patients
Unlv Medicine CurrentSince Aug 15, 2021 Accepting new patients
Unlv Medicine CurrentSince Aug 15, 2021 Accepting new patients

Locations

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

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

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

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1992209316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021973",
            "telephone_number": "702-780-2311",
            "fax_number": "702-895-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 PINTO LN FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064195",
            "telephone_number": "702-944-2828",
            "fax_number": "702-944-2852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1524 Pinto Ln Fl 2",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891064195",
            "country_code": "US",
            "telephone_number": "702-671-2236",
            "fax_number": "702-671-2233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUN",
        "first_name": "JOSEPHINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "LL3176NV",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.