Misty Kasky, DO
Individual provider Active NPI Family Medicine Physician · Fallon, NV
NPI 1124525266 · NPPES record last updated Nov 29, 2021
Key facts
- NPI
- 1124525266
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- DO2984 (NV)
- Practice address
- 1020 New River Pkwy Ste 200
Fallon, NV 89406-7801 - Phone
- (775) 428-2633
- Fax
- (775) 428-2630
- NPI assigned
- Apr 6, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Edward Via Col of Osteo Medicine-Carolinas Campus, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Banner Churchill Community Hospital
Practice addresses (Care Compare)
801 E Williams Ave
Fallon, NV 89406-3052
Phone (775) 423-3151
Hospital & facility affiliations
- Centerwell Home Health
- Banner Churchill Community Hospital
- Renown Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210826000677 | NV | Practitioner - Family Practice | 1254689623 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO2984 | NV | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Churchill Community Hospital | Current |
Accepting new patients | |
| Banner Churchill Community Hospital | Past | Accepting new patients | |
| Prime Healthcare Services - Reno LLC | Past | Accepting new patients | |
| South Lyon Health Center, Inc. | Past | Accepting new patients | |
| Mt Grant General Hospital | Past | Accepting new patients | |
| Sparks Family Hospital Inc | Past | Accepting new patients |
Locations
801 E Williams Ave
Fallon, NV 89406
Phone (775) 423-0310
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO2984 | NV | Yes |
Addresses
Primary practice location
1020 New River Pkwy Ste 200
Fallon, NV 89406-7801
Mailing address
367 S Gulph Rd
King of Prussia, PA 19406-3121
Phone (775) 428-2633
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 250015218 | Medicaid | NV | |
| V69912 | Other | NV | PTAN |
Other names
- Misty Moyle
Other providers in Fallon, NV
- Suzanne Marie Jones
- Vicki Jones
- Linda K Jorgensen
- Justine Enochs
- Carol Juul
- Ryan J Kasky
- Kay Riehm LCSW
- Sharon Keller
- Rachel Kent
- Jefferson Keyes
All providers in Fallon, NV · Family Medicine Physician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.