Active NPI
Sierra Nevada Medical Imaging Inc a Medical Corporation
- Diagnostic Radiology Physician
- South Lake Tahoe, CA
National Provider Identifier
1255310124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- SIERRA NEVADA MEDICAL IMAGING INC A MEDICAL CORPORATION
- Practice address
- 2170 South Ave
South Lake Tahoe, CA 96150 - Phone
- (559) 297-0300
- Fax
- (530) 542-9550
- NPI assigned
- Jan 10, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert Silk, MD
- Title
- President/Authorized Official
- Phone
- (775) 392-4141
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
2170 South Ave
South Lake Tahoe, CA 96150
Mailing address
PO Box 1632
Evansville, IN 47706-0033
Phone (844) 825-9300
Other practice location 1
1107 US Highway 395 N
Gardnerville, NV 89410-5304
Phone (559) 297-0300
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100507836 | Medicaid | NV | |
| CA7623 | Other | NV | RR MEDICARE |
| 100507852 | Medicaid | NV | |
| CA7624 | Other | CA | RR MEDICARE |
| GR0099310 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV, CA
Enrollment records 2
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Diagnostic Radiology Physician
- Visalia, CA
- NPI 1740250323
-
- Diagnostic Radiology Physician
- Edina, MN
- NPI 1912987942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1789171200000",
"number": "1255310124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1632",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477060033",
"telephone_number": "844-825-9300",
"fax_number": "775-852-6902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2170 SOUTH AVE",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "96150",
"telephone_number": "559-297-0300",
"fax_number": "530-542-9550"
}
],
"practiceLocations": [
{
"address_1": "1107 US Highway 395 N",
"address_purpose": "LOCATION",
"city": "Gardnerville",
"state": "NV",
"postal_code": "894105304",
"country_code": "US",
"telephone_number": "559-297-0300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SIERRA NEVADA MEDICAL IMAGING INC A MEDICAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-10",
"last_updated": "2026-09-12",
"certification_date": "2026-09-12",
"status": "A",
"authorized_official_last_name": "SILK",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "PRESIDENT/AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "775-392-4141",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100507836",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CA7623",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100507852",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CA7624",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0099310",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Lake Tahoe, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.