Individual provider Active NPI

Kyla Sweeney, PA-C

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1073280202
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0622 Issued in NV
Practice address
6630 S McCarran Blvd Ste B18
Reno, NV 89509-6136
Phone
(775) 237-2833
Fax
(775) 237-2823
NPI assigned
Aug 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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 PA0622 NV Primary

Addresses

Primary practice location

6630 S McCarran Blvd Ste B18
Reno, NV 89509-6136

Mailing address

6630 S McCarran Blvd Ste B18
Reno, NV 89509-6136
Phone (775) 237-2833

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
I20231115003371 NV Practitioner - Physician Assistant 0042601817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Gynecology of Reno PoppenGroup PAC ID 3870976095, 2 clinicians

Practice addresses (Care Compare)

6630 S McCarran Blvd
Suite 11
Reno, NV 89509-6116
Phone (775) 237-2833

Hospital & facility affiliations

  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
  • Saint Mary'S Regional Medical Center Hospital, Reno, NV, CCN 290009
  • Renown South Meadows Medical Center Hospital, Reno, NV, CCN 290049
  • Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4695OKMDSpeech-Language Pathologist
PA0622NVMDPhysician Assistant

Organizations & group practices 1

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": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1073280202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6630 S MCCARRAN BLVD STE B18",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895096136",
            "telephone_number": "775-237-2833",
            "fax_number": "775-237-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 S MCCARRAN BLVD STE B18",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895096136",
            "telephone_number": "775-237-2833",
            "fax_number": "775-237-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEENEY",
        "first_name": "KYLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA0622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.