Individual provider Active NPI

Danielle Kovaltchouk West, PA-C

  • Physician Assistant
  • Sparks, NV
National Provider Identifier
1346008489
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3030 Issued in NV
Practice address
2385 E Prater Way Ste 205
Sparks, NV 89434-9688
Phone
(775) 356-4888
NPI assigned
Mar 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3030 NV Primary
Physician Assistant 363A00000X 64231 CA

Addresses

Primary practice location

2385 E Prater Way Ste 205
Sparks, NV 89434-9688

Mailing address

6850 Sharlands Ave Unit C2010
Reno, NV 89523-2770
Phone (775) 560-1304

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
I20250820004115 NV Practitioner - Physician Assistant 8022552090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Nevada Medical Group LLCGroup PAC ID 7214093020, 83 clinicians

Practice addresses (Care Compare)

2385 E Prater Way
Suite 205
Sparks, NV 89434-9688
Phone (775) 356-4888

Hospital & facility affiliations

  • Northern Nevada Medical Center Hospital, Sparks, NV, CCN 290032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3030NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Nevada Medical Group, LLC CurrentSince Sep 15, 2025 Accepting new patients

Locations

2385 E Prater Way
Ste 205
Sparks, NV 89434
Phone (775) 356-4888

Organizations & group practices 1

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1346008489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 SHARLANDS AVE UNIT C2010",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895232770",
            "telephone_number": "775-560-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 E PRATER WAY STE 205",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894349688",
            "telephone_number": "775-356-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "DANIELLE",
        "middle_name": "KOVALTCHOUK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-12",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "3030",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "64231",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

Verify at the official NPI Registry.