Individual provider Active NPI

Tammy Roesler, M.D.

  • Pediatrics Physician
  • Reno, NV
National Provider Identifier
1215121488
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
12378 Issued in NV
Practice address
3725 Lakeside Drive
Reno, NV 89509
Phone
(775) 737-4707
Fax
(877) 548-4385
NPI assigned
Aug 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 12378 NV Primary

Addresses

Primary practice location

3725 Lakeside Drive
Reno, NV 89509

Mailing address

3725 Lakeside Drive
Reno, NV 89509
Phone (775) 737-4707

Other identifiers 1

IdentifierTypeStateIssuer
002016499MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12378NVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tammy Roesler MD PC Pediatrics Current Accepting new patients
Renown Regional Medical Center Past Accepting new patients

Locations

6512 S McCarran Blvd
Ste E
Reno, NV 89509
Phone (775) 227-2720

3725 Lakeside Dr
Reno, NV 89509
Phone (775) 737-4707

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

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1215121488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 LAKESIDE DRIVE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89509",
            "telephone_number": "775-737-4707",
            "fax_number": "877-548-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 LAKESIDE DRIVE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89509",
            "telephone_number": "775-737-4707",
            "fax_number": "877-548-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESLER",
        "first_name": "TAMMY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "12378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002016499",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.