NPIMap

Individual provider Active NPI

Steffanie Robertus, PAC

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1093386823
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2465 Issued in NV
Practice address
5560 Kietzke LN BLDG a
Reno, NV 89511-3019
Phone
(775) 322-7811
Fax
(775) 322-1431
NPI assigned
Jul 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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 PA2465 NV Primary

Addresses

Primary practice location

5560 Kietzke LN BLDG a
Reno, NV 89511-3019

Mailing address

5560 Kietzke LN
BLDG a
Reno, NV 89511-3019
Phone (775) 322-7811

Other practice location 1

10745 Double R Blvd # 13
Reno, NV 89521-8979
Phone (775) 322-7811

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
I20210803000383 NV Practitioner - Physician Assistant 4183028871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Iowa, RJ & L Carver College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology Nevada LTDGroup PAC ID 1557460557, 24 clinicians

Practice addresses (Care Compare)

5560 Kietzke LN
BLDG a
Reno, NV 89511-3019
Phone (775) 322-7811

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Nevada LTD CurrentSince Jul 1, 2021 Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Renown Regional Medical Center Past Accepting new patients
Surgery Nevada LLC Past Accepting new patients

Locations

10745 Double R Blvd
Reno, NV 89521
Phone (775) 322-7811

5560 Kietzke Ln
Bldg A
Reno, NV 89511
Phone (775) 322-7811

10745 Double R Blvd
#13
Reno, NV 89521
Phone (775) 322-7811

5560 Kietzke Ln
Reno, NV 89511
Phone (775) 284-1612

5070 Ion Dr
Ste 201
Sparks, NV 89436
Phone (775) 322-7811

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19482/brand/1/csg/1/fhir/r4
  • Direct secure messaging: steffanie.robertus.1@19482.direct.athenahealth.com

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 12

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": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1093386823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5560 KIETZKE LN",
            "address_2": "BLDG A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113019",
            "telephone_number": "775-322-7811",
            "fax_number": "775-322-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5560 KIETZKE LN BLDG A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113019",
            "telephone_number": "775-322-7811",
            "fax_number": "775-322-1431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10745 Double R Blvd # 13",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895218979",
            "country_code": "US",
            "telephone_number": "775-322-7811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTUS",
        "first_name": "STEFFANIE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.