NPIMap

Individual provider Active NPI

Jeromy Dyer

  • Physician Assistant
  • Carson City, NV
National Provider Identifier
1003927633
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0335 Issued in NV
Practice address
973 Mica Drive
Suite 201
Carson City, NV 89705-7255
Phone
(775) 783-6190
Fax
(775) 783-6191
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0335 NV Primary
Physician Assistant 363A00000X PA15875 CA

Addresses

Primary practice location

973 Mica Drive
Suite 201
Carson City, NV 89705-7255

Mailing address

973 Mica Dr
Suite 201
Carson City, NV 89705-7255
Phone (775) 783-6190

Other identifiers 1

IdentifierTypeStateIssuer
0PA158750MedicaidCA

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
I20160624002006 NV Practitioner - Physician Assistant 0143381269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James J Lynch M D LTDGroup PAC ID 9133188626, 81 clinicians
Custom Physical Therapy Limited PartnershipGroup PAC ID 1355252842, shared by 2 NPIs, 76 clinicians

Practice addresses (Care Compare)

10539 Professional Cir
Suite 201
Reno, NV 89521-3858
Phone (775) 793-6190

1470 Medical Pkwy
Suite 220
Carson City, NV 89703-4647
Phone (775) 348-8800

440 E Golden Valley Rd
Reno, NV 89506-5722
Phone (775) 360-3000

973 Mica Dr
Suite 201
Carson City, NV 89705-7258
Phone (775) 783-6190

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.71 of 100Reported as apm
Quality
81.42
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA15875CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
James J Lynch M D LTD CurrentSince Jan 1, 2022 Accepting new patients
James J Lynch MD LTD CurrentSince Jan 1, 2022 Accepting new patients

Locations

2874 N Carson St
Ste 210
Carson City, NV 89706
Phone (775) 883-5955

973 Mica Dr
Ste 201
Carson City, NV 89705
Phone (702) 884-5470

2874 N Carson St
Ste 105
Carson City, NV 89706
Phone (775) 283-3321

1470 Medical Pkwy
Ste 220
Carson City, NV 89703

1749 N Stewart St
Ste 50
Carson City, NV 89706
Phone (775) 392-3689

9990 Double R Blvd
Ste 200
Reno, NV 89521
Phone (753) 488-8008

10539 Professional Cir
Ste 201
Reno, NV 89521
Phone (775) 674-5632

Interoperability endpoints

  • Direct secure messaging: jeromy.dyer.1@22724.direct.athenahealth.com

Organizations & group practices 2

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 8

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1003927633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "973 MICA DR",
            "address_2": "SUITE 201",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897057255",
            "telephone_number": "775-783-6190",
            "fax_number": "775-783-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "973 MICA DRIVE",
            "address_2": "SUITE 201",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897057255",
            "telephone_number": "775-783-6190",
            "fax_number": "775-783-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "JEROMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA0335",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15875",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0PA158750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.