Individual provider Active NPI

Malynda Lynn Tushbant, PA-C

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1235469446
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0200 Issued in NV
Practice address
580 W 5TH St
Reno, NV 89503-4407
Phone
(775) 786-4673
Fax
(775) 348-2889
NPI assigned
Jan 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 PA0200 NV Primary

Addresses

Primary practice location

580 W 5TH St
Reno, NV 89503-4407

Mailing address

580 W 5TH St
Reno, NV 89503-4407
Phone (775) 786-4673

Other identifiers 3

IdentifierTypeStateIssuer
PA0200OtherNVLICENSE
CZ375ZOtherMEDICARE PTAN
PA1737OtherNVLICENSE

Other names 1

  • Malynda Lynn Calkins Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100504000278 NV Practitioner - Physician Assistant 2062540560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

580 W 5TH St
Reno, NV 89503-4407
Phone (775) 786-4673

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA0200NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Springs CurrentSince Sep 11, 2016 Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Northern Nevada HIV Outpatient Program, Education and Services Past Accepting new patients
Mt Grant General Hospital Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients

Locations

580 W 5th St
Reno, NV 89503
Phone (775) 786-4673

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1235469446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 W 5TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034407",
            "telephone_number": "775-786-4673",
            "fax_number": "775-348-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W 5TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034407",
            "telephone_number": "775-786-4673",
            "fax_number": "775-348-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUSHBANT",
        "first_name": "MALYNDA",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA0200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA0200",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CZ375Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA1737",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALYNDA",
            "last_name": "CALKINS",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.