NPIMap

Individual provider Active NPI

Jeremy Lee Reichert, PA-C

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1215130802
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA925 Issued in NV
Practice address
5560 Kietzke LN.
BLDG. a
Reno, NV 89511
Phone
(775) 322-7811
Fax
(775) 322-1431
NPI assigned
Jun 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18021 CA
Physician Assistant 363A00000X PA925 NV Primary

Addresses

Primary practice location

5560 Kietzke LN.
BLDG. a
Reno, NV 89511

Mailing address

5560 Kietzke LN.
BLDG. a
Reno, NV 89511
Phone (775) 322-7811

Other practice location 1

1500 E 2nd St Ste 300
Reno, NV 89502-1198
Phone (775) 322-7811

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
I20050929001310 NV Practitioner - Physician Assistant 5991730707 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
Group practices
Urology Nevada LTDGroup PAC ID 1557460557, 24 clinicians

Practice addresses (Care Compare)

5560 Kietzke LN
BLDG a
Reno, NV 89511-3019
Phone (775) 322-7811

Hospital & facility affiliations

  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
  • Northern Nevada Medical Center Hospital, Sparks, NV, CCN 290032
  • Renown South Meadows Medical Center Hospital, Reno, NV, CCN 290049
  • Saint Mary'S Regional Medical Center Hospital, Reno, NV, CCN 290009
  • Humboldt General Hospital Hospital, Winnemucca, NV, CCN 291308

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA18021CAMDPhysician Assistant
PA925NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Nevada LTD CurrentSince Apr 9, 2012 Accepting new patients

Locations

1500 E 2nd St
Ste 300
Reno, NV 89502
Phone (775) 322-7811

235 W 6th St
Reno, NV 89503
Phone (775) 746-3202

5560 Kietzke Ln
Reno, NV 89511
Phone (775) 284-1612

5560 Kietzke Ln
Bldg A
Reno, NV 89511
Phone (775) 322-7811

10745 Double R Blvd
Reno, NV 89521
Phone (775) 322-7811

5070 Ion Dr
Ste 201
Sparks, NV 89436
Phone (775) 322-7811

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19482/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1181347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1215130802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5560 KIETZKE LN.",
            "address_2": "BLDG. A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89511",
            "telephone_number": "775-322-7811",
            "fax_number": "775-322-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5560 KIETZKE LN.",
            "address_2": "BLDG. A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89511",
            "telephone_number": "775-322-7811",
            "fax_number": "775-322-1431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E 2nd St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895021198",
            "country_code": "US",
            "telephone_number": "775-322-7811",
            "fax_number": "775-322-1431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REICHERT",
        "first_name": "JEREMY",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-09",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18021",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.