NPIMap

Organization Active NPI

Sierra Neurosurgery Group

  • Neurological Surgery Physician
  • Reno, NV
National Provider Identifier
1295914661
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
SIERRA NEUROSURGERY GROUP
Practice address
5590 Kietzke LN
Reno, NV 89511-3019
Phone
(775) 323-2080
Fax
(775) 323-8216
NPI assigned
Nov 1, 2007
Last updated
Mar 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Authorized official

Name
Flora Gallegos
Title
Ceo
Phone
(775) 789-3930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X NU Primary

Addresses

Primary practice location

5590 Kietzke LN
Reno, NV 89511-3019

Mailing address

5590 Kietzke LN
Reno, NV 89511-3019
Phone (775) 323-2080

Other practice location 1

5070 Ion Dr Ste 200
Sparks, NV 89436-1654
Phone (775) 323-2080

Other identifiers 1

IdentifierTypeStateIssuer
100508864MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040420000138 NV Part B Supplier - Clinic/Group Practice 3870588619 Receives reassigned benefits from 27 practitioners
Practice locations: Reno, NV
O20101027000755 NV DME Supplier - Physician - Neurosurgery 3870588619 Practice locations: Reno, NV
O20141001001679 CA Part B Supplier - Clinic/Group Practice 3870588619 Receives reassigned benefits from 2 practitioners
Practice locations: Bishop, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2050563Sierra Neurosurgery Group5590 Kietzke LN, Reno, NV 89511Certificate of waiverNov 29, 2026

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13729/brand/6/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1295914661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5590 KIETZKE LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113019",
            "telephone_number": "775-323-2080",
            "fax_number": "775-323-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5590 KIETZKE LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113019",
            "telephone_number": "775-323-2080",
            "fax_number": "775-323-8216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5070 Ion Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Sparks",
            "state": "NV",
            "postal_code": "894361654",
            "country_code": "US",
            "telephone_number": "775-323-2080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SIERRA NEUROSURGERY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "GALLEGOS",
        "authorized_official_first_name": "FLORA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "775-789-3930"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100508864",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.