Active NPI
Amy Marie Villaret, PA
- Physician Assistant
- Incline Village, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA1281
- Practice address
- 925 Tahoe Blvd Ste 105
Incline Village, NV 89451-7498 - Phone
- (775) 580-7600
- Fax
- (775) 831-0946
- NPI assigned
- Feb 16, 2011
- Last updated
- Aug 27, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA1281 | NV | Primary |
| Physician Assistant | 363A00000X | PA21440 | CA |
Addresses
Primary practice location
925 Tahoe Blvd Ste 105
Incline Village, NV 89451-7498
Mailing address
1111 Emerald Bay Rd
South Lake Tahoe, CA 96150-6207
Phone (530) 543-5659
Other names 1
- Amy Marie Czesnowski
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
155 Hwy 50
Stateline, NV 89449-9816
Phone (775) 589-8900
165 Hwy 50
Stateline, NV 89449-9816
Phone (775) 589-8950
2074 Lake Tahoe Blvd
Suite 4
South Lake Tahoe, CA 96150-6408
Phone (530) 543-5554
2170 B S Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 539-6620
2170 S Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 543-5807
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.71 of 100
- Quality
- 89.85
- Promoting interoperability
- 94.05
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.71 of 100
- Quality
- 89.85
- Promoting interoperability
- 94.05
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21440 | CA | MD | Pharmacist |
| PA1281 | NV | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tahoe Carson Valley Medical Group Inc | Current | Accepting new patients | |
| Lake Tahoe Orthopaedic Institute, a Watson-Swanson Professional Corp | Physician Assistant | Current | Accepting new patients |
Locations
1090 3rd St
South Lake Tahoe, CA 96150
Phone (530) 543-5660
1111 Emerald Bay Rd
South Lake Tahoe, CA 96150
Phone (530) 543-5659
1139 3rd St
South Lake Tahoe, CA 96150
Phone (530) 541-3100
2170 South Ave
South Lake Tahoe, CA 96150
Phone (530) 541-3420
2170 South Ave
#B
South Lake Tahoe, CA 96150
Phone (530) 539-6620
925 Tahoe Blvd
Ste 105
Incline Village, NV 89451
Phone (530) 543-5799
Interoperability endpoints
- avillaret65513@direct.renown.org
Organizations & group practices 4
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.
-
dba Tahoe Orthopedics and Sports Medicine
- Orthopaedic Surgery Physician
- Zephyr Cove, NV
- NPI 1609937911
Physician Assistant
-
- Family Medicine Physician
- South Lake Tahoe, CA
- NPI 1508865528
-
- Orthopaedic Surgery Physician
- South Lake Tahoe, CA
- NPI 1902131287
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Carson City, NV
- NPI 1255360160
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Carson City, NV
- NPI 1568281988
Hospital
-
dba CVMC Outpatient Behavioral Health Clinic
- Community/Behavioral Health Agency
- Gardnerville, NV
- NPI 1104482918
Hospital
-
dba Carson Valley Health
- Critical Access Hospital
- Gardnerville, NV
- NPI 1396799102
-
dba Barton Memorial Hospital
- General Acute Care Hospital
- South Lake Tahoe, CA
- NPI 1003867565
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440633600000",
"number": "1255638870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 EMERALD BAY RD",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961506207",
"telephone_number": "530-543-5659",
"fax_number": "530-541-8723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 TAHOE BLVD STE 105",
"city": "INCLINE VILLAGE",
"state": "NV",
"postal_code": "894517498",
"telephone_number": "775-580-7600",
"fax_number": "775-831-0946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLARET",
"first_name": "AMY",
"middle_name": "MARIE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-16",
"last_updated": "2015-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NV",
"license": "PA1281",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA21440",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "CZESNOWSKI",
"middle_name": "MARIE",
"credential": "PA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Incline Village, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.