Kimberly Jean Radai, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA880 Issued in NV

Practice address

1020 New River Pkwy Ste 200
Fallon, NV 89406

Phone

(775) 428-2633

Fax

(775) 428-2630

NPI assigned

Apr 3, 2006

Last updated

Jun 22, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Northern Nevada Medical Group, LLC

  • Family Medicine Physician
  • Sparks, NV
  • NPI 1972751618
  Medicare reassignment

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1174585517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3046",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193550746",
            "telephone_number": "775-428-2633",
            "fax_number": "775-428-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 NEW RIVER PKWY STE 200",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "89406",
            "telephone_number": "775-428-2633",
            "fax_number": "775-428-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADAI",
        "first_name": "KIMBERLY",
        "middle_name": "JEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174585517",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Potter, MFT
• Florina Prentice
• Tami Lynnette Prior
• David John Probst, D.D.S.
• Carolyn Prohaska, ST
• Rally Rehab and Wellness LLC
• Andreina Ramirez
• Kimberly Sue Rechel
• Red Dog Counseling
• Rehab & Industrial Services, LLP (Rehab Services of Nevada - Fallon)

• Physician Assistant in Fallon, NV
• Providers in Fallon, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.