Individual provider Active NPI

Taryn Noel Perez, PAC

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1043971161
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2910 Issued in NV
Practice address
1500 E 2ND St Ste 206
Reno, NV 89502-1198
Phone
(775) 982-5000
Fax
(775) 982-3900
NPI assigned
Jan 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2910 NV Primary

Addresses

Primary practice location

1500 E 2ND St Ste 206
Reno, NV 89502-1198

Mailing address

1155 Mill St # M14
Reno, NV 89502-1576
Phone (775) 982-5262

Other identifiers 2

IdentifierTypeStateIssuer
PA2910OtherNVPAC NEVADA
16085470OtherNVCAQH

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240125000409 NV Practitioner - Physician Assistant 8022461136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nevada School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians

Practice addresses (Care Compare)

10101 Double R Blvd
Reno, NV 89521-5931
Phone (775) 982-7878

10201 Double R Blvd
Reno, NV 89521-6091

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2910NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC Physician Assistant CurrentSince Feb 1, 2024 Accepting new patients
Community Care Services LLC CurrentSince Feb 1, 2024 Accepting new patients
Community Care Services LLC Past Accepting new patients

Locations

1155 Mill St
#M14
Reno, NV 89502
Phone (775) 258-1970

1500 E 2nd St
Ste 206
Reno, NV 89502
Phone (775) 789-7000

10201 Double R Blvd
Ste 315
Reno, NV 89521
Phone (775) 982-3443

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

Interoperability endpoints

  • Direct secure messaging: tperez188988@direct.renown.org

Organizations & group practices 4

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 3

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": "1641081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1043971161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST # M14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E 2ND ST STE 206",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021198",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "TARYN",
        "middle_name": "NOEL",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-02",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PAC NEVADA",
            "identifier": "PA2910",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "16085470",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.