NPIMap

Individual provider Active NPI

Polina Zykova, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Reno, NV
National Provider Identifier
1174054761
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
23616 Issued in NV
Practice address
10085 Double R Blvd Ste 310
Reno, NV 89521-4832
Phone
(775) 982-7260
Fax
(775) 982-7268
NPI assigned
Mar 24, 2017
Last updated
May 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 23616 NV Primary

Addresses

Primary practice location

10085 Double R Blvd Ste 310
Reno, NV 89521-4832

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
23616OtherNVNEVADA MD LICENSE
15739725OtherNVCAQH NUMBER

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
I20230526000917 NV Practitioner - Endocrinology 8820359920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians

Practice addresses (Care Compare)

10085 Double R Blvd
Suite 310
Reno, NV 89521-4832
Phone (775) 982-7260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
79.09
Promoting interoperability
100
Improvement activities
40
Cost
71.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23616NVMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC CurrentSince May 12, 2023 Accepting new patients
First Choice Physician Partners Current Accepting new patients
First Choice Physician Partners CurrentSince Nov 14, 2022 Accepting new patients
Community Care Services LLC Current Accepting new patients
First Choice Physician Partners CurrentSince Nov 14, 2022 Accepting new patients
Community Care Services LLC CurrentSince May 12, 2023 Accepting new patients
First Choice Physician Partners Past Accepting new patients
Community Care Services LLC Past Accepting new patients

Locations

6955 El Camino Real
Ste 200
Atascadero, CA 93422
Phone (805) 394-4980

1064 Murray Ave
Sn Luis Obisp, CA 93405
Phone (805) 316-3733

10085 Double R Blvd
Ste 310
Reno, NV 89521
Phone (775) 324-2234

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

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

Interoperability endpoints

  • Direct secure messaging: pzykova197134@direct.renown.org

Organizations & group practices 8

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 6

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1174054761",
    "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": "775-982-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10085 DOUBLE R BLVD STE 310",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895214832",
            "telephone_number": "775-982-7260",
            "fax_number": "775-982-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZYKOVA",
        "first_name": "POLINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NV",
            "license": "23616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA MD LICENSE",
            "identifier": "23616",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "15739725",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.