NPIMap

Individual provider Active NPI

Vadim Alec Gladwill, MD

  • Hospitalist Physician
  • Reno, NV
National Provider Identifier
1093275307
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
22564 Issued in NV
Practice address
1155 Mill St
Reno, NV 89502-1576
Phone
(775) 982-7878
Fax
(775) 982-4196
NPI assigned
Mar 22, 2019
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22564 NV
Hospitalist Physician 208M00000X 22564 NV Primary

Addresses

Primary practice location

1155 Mill St
Reno, NV 89502-1576

Mailing address

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

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
I20220912003534 NV Practitioner - HospitalistPractitioner - Internal Medicine 3274865803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carson Valley Medical Center Rural Health ClinicGroup PAC ID 2860579984, 43 clinicians

Practice addresses (Care Compare)

1107 US Hwy 395 N
Gardnerville, NV 89410-5304
Phone (775) 782-1500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22564NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC CurrentSince Sep 1, 2022 Accepting new patients
Carson Valley Medical Center Rural Health Clinic Internal Medicine CurrentSince Oct 1, 2023 Accepting new patients
Community Care Services LLC Internal Medicine CurrentSince Sep 1, 2022 Accepting new patients
Washoe Barton Medical Clinic a Nevada Nonprofit Corporation Past Accepting new patients

Locations

1107 US Highway 395 N
Gardnerville, NV 89410
Phone (775) 782-1595

1520 Virginia Ranch Rd
Gardnerville, NV 89410
Phone (775) 782-1550

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

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

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

1495 Mill St
Reno, NV 89502
Phone (775) 982-3500

Interoperability endpoints

  • Direct secure messaging: vgladwill148594@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1093275307",
    "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": "775-982-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 MILL ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-7878",
            "fax_number": "775-982-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADWILL",
        "first_name": "VADIM",
        "middle_name": "ALEC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "22564",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "22564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.