NPIMap

Individual provider Active NPI

Benjamin Dale Prohaska, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1174652143
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA943 Issued in NV
Practice address
10085 Double R Blvd
Ste 310
Reno, NV 89521
Phone
(775) 982-7260
Fax
(775) 982-7268
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA943 NV Primary

Addresses

Primary practice location

10085 Double R Blvd
Ste 310
Reno, NV 89521

Mailing address

5444 Reno Corporate Dr
Reno, NV 89511-2250
Phone (775) 786-6770

Other identifiers 2

IdentifierTypeStateIssuer
P00426676OtherNVRAILROAD MEDICARE
12780456OtherCAQH

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
I20071105000015 NV Practitioner - Physician Assistant 0749377976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nitesh D Kuhadiya MD MPH PLLCGroup PAC ID 1759796717, 6 clinicians
Pershing General HospitalGroup PAC ID 7012825433, shared by 4 NPIs, 13 clinicians

Practice addresses (Care Compare)

5444 Reno Corporate Dr
Reno, NV 89511-2250
Phone (775) 507-2555

PO Box
Suite 661
Lovelock, NV 89419-0661

Hospital & facility affiliations

  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
  • Northern Nevada Medical Center Hospital, Sparks, NV, CCN 290032
  • Banner Lassen Medical Center Hospital, Susanville, CA, CCN 051320
  • Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019
  • Renown South Meadows Medical Center Hospital, Reno, NV, CCN 290049

Merit-based Incentive Payment System (MIPS)

Final score
84.29 of 100Reported as group
Quality
88.02
Improvement activities
40
Cost
63.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Renown Regional Medical Center Past Accepting new patients

Organizations & group practices 2

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 12

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1174652143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5444 RENO CORPORATE DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112250",
            "telephone_number": "775-786-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10085 DOUBLE R BLVD",
            "address_2": "STE 310",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89521",
            "telephone_number": "775-982-7260",
            "fax_number": "775-982-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROHASKA",
        "first_name": "BENJAMIN",
        "middle_name": "DALE",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00426676",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12780456",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.