NPIMap

Individual provider Active NPI

Jonathan P Pezanoski, MD

  • Gastroenterology Physician
  • Reno, NV
National Provider Identifier
1053355545
Registry record updated Oct 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
12280 Issued in NV
Practice address
10619 Professional Cir
Reno, NV 89521-5831
Phone
(775) 852-4848
Fax
(775) 850-5763
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 12280 NV Primary

Addresses

Primary practice location

10619 Professional Cir
Reno, NV 89521-5831

Mailing address

10619 Professional Cir
Reno, NV 89521-5831
Phone (775) 852-4848

Other identifiers 1

IdentifierTypeStateIssuer
VWCGZBOtherNVGROUP MEDICARE PIN

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
I20070727000337 NV Practitioner - GastroenterologyPractitioner - Internal Medicine 5890708036 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Consultants LTDGroup PAC ID 0941107478, 39 clinicians

Practice addresses (Care Compare)

880 Ryland St
Reno, NV 89502-1603
Phone (775) 329-4600

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

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
79.09
Promoting interoperability
100
Improvement activities
40
Cost
71.43

Merit-based Incentive Payment System (MIPS)

Final score
96.42 of 100Reported as group
Quality
93.48
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy287
Upper gastrointestinal (GI) endoscopy for acid reflux532

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC CurrentSince Jan 26, 2023 Accepting new patients
Community Care Services LLC Gastroenterology CurrentSince Jan 26, 2023 Accepting new patients
Community Care Services LLC Current Accepting new patients
Gastroenterology Consultants, LTD CurrentSince Aug 1, 2007 Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Renown Regional Medical Center Past Accepting new patients

Locations

880 Ryland St
Reno, NV 89502
Phone (775) 329-4600

10619 Professional Cir
Reno, NV 89521
Phone (775) 329-4600

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

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

Interoperability endpoints

  • Direct secure messaging: jpezanoski987@direct.renown.org

Organizations & group practices 6

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 9

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191801600000",
    "number": "1053355545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10619 PROFESSIONAL CIR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215831",
            "telephone_number": "775-852-4848",
            "fax_number": "775-850-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10619 PROFESSIONAL CIR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215831",
            "telephone_number": "775-852-4848",
            "fax_number": "775-850-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZANOSKI",
        "first_name": "JONATHAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NV",
            "license": "12280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PIN",
            "identifier": "VWCGZB",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.