Organization Active NPI

Nevada Center for Dermatology

  • Specialist
  • Reno, NV
National Provider Identifier
1326252131
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
8902 Issued in NV
Legal business name
NEVADA CENTER FOR DERMATOLOGY
Practice address
650 Sierra Rose Dr
Ste. a
Reno, NV 89511-2081
Phone
(775) 827-8100
NPI assigned
May 10, 2007
Last updated
May 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Authorized official

Name
Kenji Sax
Title
Practice Manager
Phone
(775) 827-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 8902 NV Primary

Addresses

Primary practice location

650 Sierra Rose Dr
Ste. a
Reno, NV 89511-2081

Mailing address

650 Sierra Rose Dr
Ste. a
Reno, NV 89511-2357
Phone (775) 827-8100

Other identifiers 1

IdentifierTypeStateIssuer
CJ7776OtherNVMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040714000864 NV Part B Supplier - Clinic/Group Practice 7810976891 Receives reassigned benefits from 4 practitioners
Practice locations: Reno, NV

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
29D0965583Nevada Center for Dermatology650 Sierra Rose Drive Suite a, Reno, NV 89511ComplianceJan 11, 2028

National Provider Directory

National Provider Directory

Locations

650 Sierra Rose Dr
Ste A
Reno, NV 89511
Phone (775) 827-8100

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1326252131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 SIERRA ROSE DR",
            "address_2": "STE. A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112357",
            "telephone_number": "775-827-8100",
            "fax_number": "775-827-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 SIERRA ROSE DR",
            "address_2": "STE. A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112081",
            "telephone_number": "775-827-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA CENTER FOR DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "SAX",
        "authorized_official_first_name": "KENJI",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "775-827-8100"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NV",
            "license": "8902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CJ7776",
            "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 May 26, 2015; 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.