NPIMap

Individual provider Active NPI

Gretchen Goicoechea, P.A.

  • Medical Physician Assistant
  • Reno, NV
National Provider Identifier
1003808536
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA632 Issued in NV
Practice address
75 Pringle Way
Suite 401
Reno, NV 89502-1464
Phone
(775) 688-8000
Fax
(775) 688-8031
NPI assigned
Aug 19, 2005
Last updated
Jun 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA632 NV Primary

Addresses

Primary practice location

75 Pringle Way
Suite 401
Reno, NV 89502-1464

Mailing address

75 Pringle Way
Suite 401
Reno, NV 89502-1464
Phone (775) 688-8000

Other identifiers 1

IdentifierTypeStateIssuer
100503015MedicaidNV

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
I20040326000652 NV Practitioner - Physician Assistant 6002708807 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Challapalli Cardiology PCGroup PAC ID 1456723162, 8 clinicians

Practice addresses (Care Compare)

5375 Reno Corporate Dr
Reno, NV 89511-2381
Phone (775) 384-1134

5385 Reno Corporate Dr
Reno, NV 89511-2368
Phone (775) 384-1134

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Mary's Medical Group Inc CurrentSince Apr 13, 2013 Accepting new patients
Renown Regional Medical Center Past Accepting new patients
Renown Urgent Care LLC Past Accepting new patients

Locations

1801 W Olympic Blvd
#1461
Pasadena, CA 91199

18653 Wedge Pkwy
Ste 110
Reno, NV 89511
Phone (775) 352-7201

Interoperability endpoints

  • Direct secure messaging: gretchen.goicoechea.1@27787.direct.athenahealth.com
  • Direct secure messaging: gretchen.goicoechea.p1@direct.smmg.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1003808536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 PRINGLE WAY",
            "address_2": "SUITE 401",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021464",
            "telephone_number": "775-688-8000",
            "fax_number": "775-688-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PRINGLE WAY",
            "address_2": "SUITE 401",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021464",
            "telephone_number": "775-688-8000",
            "fax_number": "775-688-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOICOECHEA",
        "first_name": "GRETCHEN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100503015",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.