Provider Demographics
NPI:1528216090
Name:TSAI, JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:TSAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 PALOMINO LN STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4894
Mailing Address - Country:US
Mailing Address - Phone:702-759-8779
Mailing Address - Fax:702-384-1815
Practice Address - Street 1:6800 W. 138TH TERRACE
Practice Address - Street 2:APT 911
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-7816
Practice Address - Country:US
Practice Address - Phone:702-759-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV141362085R0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1528216090Medicaid
OK200471300AMedicaid
CA1528216090Medicaid
CAP01330556OtherRR MEDICARE DRS
KSP01344658OtherRR MEDICARE KS DSOL
CAP01069024OtherRR DR CA
NVFM205ZMedicare PIN
KSP01344658OtherRR MEDICARE KS DSOL
CA1528216090Medicaid
KSKA3115001Medicare PIN
CACA116210Medicare PIN
CACA110974Medicare PIN
KSKA3112001Medicare PIN
CAP01069024OtherRR DR CA
NV1528216090Medicaid