NPIMap

Individual provider Active NPI

Mel C. Magboo, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Reno, NV
National Provider Identifier
1114937158
Registry record updated Oct 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
9713 Issued in NV
Practice address
5250 Neil Rd
#207
Reno, NV 89502-6542
Phone
(775) 398-1981
Fax
(775) 398-1984
NPI assigned
Aug 9, 2006
Last updated
Oct 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 9713 NV Primary

Addresses

Primary practice location

5250 Neil Rd
#207
Reno, NV 89502-6542

Mailing address

5250 Neil Rd
#207
Reno, NV 89502-6542
Phone (775) 398-1981

Other identifiers 1

IdentifierTypeStateIssuer
001516770MedicaidNV

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
I20040511000322 NV Practitioner - Internal MedicinePractitioner - Geriatric Medicine 9133118532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5335 Reno Corporate Dr
Suite 100
Reno, NV 89511-2619
Phone (775) 432-6282

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
20.83 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
69.45

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reno Geriatrics LLC Geriatric Medicine CurrentSince May 1, 2018 Accepting new patients
Renown Regional Medical Center PastSince May 1, 2018 Accepting new patients
Wildcreek Healthcare, Inc. Past Accepting new patients
Dimensions Management of Northern Nevada, LLC Past Accepting new patients
Revive Health Senior Care LLC Past Accepting new patients
Avalon Care Center - VA Reno LLC Past Accepting new patients

Locations

5335 Reno Corporate Dr
Ste 100
Reno, NV 89511
Phone (757) 432-6282

555 Hammill Ln
Reno, NV 89511
Phone (775) 828-5600

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rosewood Rehabilitaion CenterReno, NV, CCN 295020 Skilled nursing facility Operational/Managerial Control
Managing Control - Governing Body
Adp of the SNF		 Dec 15, 2015
Dec 15, 2015
Dec 15, 2015
Alta Skilled Nursing and Rehabilitation CenterReno, NV, CCN 295077 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2019
Feb 1, 2019
Northern Nevada State Veterans HomeSparks, NV, CCN 295105 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 14, 2020
May 14, 2020
Eden HospiceReno, NV, CCN 291515 Hospice W-2 Managing Employee (100%) Jan 1, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254355200000",
    "number": "1114937158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 NEIL RD",
            "address_2": "#207",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895026542",
            "telephone_number": "775-398-1981",
            "fax_number": "775-398-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 NEIL RD",
            "address_2": "#207",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895026542",
            "telephone_number": "775-398-1981",
            "fax_number": "775-398-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGBOO",
        "first_name": "MEL",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2009-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NV",
            "license": "9713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001516770",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.