Individual provider Active NPI

Brad William Hammon, D.O.

  • Dermatology Physician
  • Reno, NV
National Provider Identifier
1114388204
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
DO2956 Issued in NV
Practice address
640 W Moana LN
Reno, NV 89509-4903
Phone
(775) 350-7831
NPI assigned
Mar 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X DO2956 NV Primary

Addresses

Primary practice location

640 W Moana LN
Reno, NV 89509-4903

Mailing address

640 W Moana LN
Reno, NV 89509-4903
Phone (775) 324-0699

Other practice location 1

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-4882

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210914003076 NV Practitioner - Dermatology 9335545441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Rocky Vista University College of Osteopathic Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain West Derm - Blackhart PLLCGroup PAC ID 1153609813, 103 clinicians

Practice addresses (Care Compare)

3640 Warren Way
Reno, NV 89509-5240
Phone (775) 324-0699

9672 S McCarran Blvd
Reno, NV 89523-9205
Phone (775) 324-0699

Hospital & facility affiliations

  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision69
Removal of skin lesions1498
Removal or shaving of skin growth1-10
Skin biopsy263

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO2956NVMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Cancer and Dermatology Institute Current Accepting new patients
Mountain West Derm - Blackhart PLLC CurrentSince Sep 1, 2021 Accepting new patients
Mountain West Derm-Blackhart, PLLC Dermatology CurrentSince Sep 1, 2021 Accepting new patients
South Lyon Health Center, Inc. Past Accepting new patients
Mt Grant General Hospital Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients

Locations

640 W Moana Ln
Reno, NV 89509
Phone (775) 882-8777

3640 Warren Way
Ste 100
Reno, NV 89509

Interoperability endpoints

  • Direct secure messaging: bhammon@skincancerderm.emadirect.md

Organizations & group practices 7

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 2

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": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1114388204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 W MOANA LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895094903",
            "telephone_number": "775-324-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 W MOANA LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895094903",
            "telephone_number": "775-350-7831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Olentangy River Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "43214",
            "country_code": "US",
            "telephone_number": "614-566-4882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMMON",
        "first_name": "BRAD",
        "middle_name": "WILLIAM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-16",
        "last_updated": "2021-07-20",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NV",
            "license": "DO2956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.