Individual provider Active NPI

Katherine Sue Manno, MD

  • Dermatology Physician
  • Reno, NV
National Provider Identifier
1225474224
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
17213 Issued in NV
Practice address
6536 S McCarran Blvd Ste B
Reno, NV 89509-6152
Phone
(775) 982-5595
Fax
(775) 982-4774
NPI assigned
May 16, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 17213 NV Primary

Addresses

Primary practice location

6536 S McCarran Blvd Ste B
Reno, NV 89509-6152

Mailing address

850 Harvard Way
Reno, NV 89502-2055
Phone (775) 982-5262

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170928000828 NV Practitioner - Dermatology 7517263031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Rush Medical College of Rush University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3640 Warren Way
Suite 100
Reno, NV 89509-5240
Phone (775) 324-0699

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision98
Removal of skin lesions2258
Removal or shaving of skin growth1-10
Skin biopsy648

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Cancer and Dermatology Institute Current Accepting new patients
Mountain West Derm-Blackhart, PLLC Dermatology CurrentSince Oct 7, 2019 Accepting new patients
Mountain West Derm - Blackhart PLLC CurrentSince Oct 7, 2019 Accepting new patients

Locations

3640 Warren Way
Ste 100
Reno, NV 89509

640 W Moana Ln
Reno, NV 89509
Phone (775) 882-8777

Organizations & group practices 3

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 2

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": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1225474224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARVARD WAY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022055",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6536 S MCCARRAN BLVD STE B",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895096152",
            "telephone_number": "775-982-5595",
            "fax_number": "775-982-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNO",
        "first_name": "KATHERINE",
        "middle_name": "SUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NV",
            "license": "17213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.