NPIMap

Individual provider Active NPI

Star Ray Chenoweth, PA-C

  • Surgical Physician Assistant
  • Carson City, NV
National Provider Identifier
1386970614
Registry record updated Oct 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA1183 Issued in NV
Practice address
973 Mica Dr
Suite 201
Carson City, NV 89705-7255
Phone
(775) 783-6190
Fax
(775) 783-6191
NPI assigned
Oct 21, 2009
Last updated
Oct 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA1183 NV
Surgical Physician Assistant 363AS0400X PA1183 NV Primary

Addresses

Primary practice location

973 Mica Dr
Suite 201
Carson City, NV 89705-7255

Mailing address

973 Mica Dr
Suite 201
Carson City, NV 89705-7255
Phone (775) 783-6190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100111000627 NV Practitioner - Physician Assistant 1951442078 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Humboldt General HospitalGroup PAC ID 5193709798, 41 clinicians
Robert G Berry Jr Elko Chartered LLCGroup PAC ID 0446573380, 9 clinicians

Practice addresses (Care Compare)

118 E Haskell St
Winnemucca, NV 89445-3247
Phone (775) 623-5222

2219 N 5TH St
Elko, NV 89801-2483

2219 N 5TH St
Suite a
Elko, NV 89801-2473
Phone (775) 777-9669

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.36 of 100Reported as individual
Quality
72.94
Promoting interoperability
100
Improvement activities
40
Cost
72.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA1183NVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Humboldt General Hospital CurrentSince Dec 1, 2020 Accepting new patients
William Bee Ririe Retail Pharmacy CurrentSince Nov 24, 2020 Accepting new patients
Banner Churchill Community Hospital Past Accepting new patients
Renown Regional Medical Center Past Accepting new patients
Robert G Berry Jr MD PastSince Oct 16, 2022 Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients

Locations

1500 Avenue H
Ely, NV 89301
Phone (775) 289-3001

6 Steptoe Cir
Ely, NV 89301
Phone (775) 289-3001

118 E Haskell St
Winnemucca, NV 89445
Phone (775) 623-5222

Interoperability endpoints

  • Direct secure messaging: elkospineandrehab.starchenoweth@140990.advancedmd-direct.com

Organizations & group practices 11

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.

Hospital & facility affiliations 5

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": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286150400000",
    "number": "1386970614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "973 MICA DR",
            "address_2": "SUITE 201",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897057255",
            "telephone_number": "775-783-6190",
            "fax_number": "775-783-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "973 MICA DR",
            "address_2": "SUITE 201",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897057255",
            "telephone_number": "775-783-6190",
            "fax_number": "775-783-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENOWETH",
        "first_name": "STAR",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-21",
        "last_updated": "2010-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA1183",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA1183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.