Individual provider Active NPI

Shanae Vizza, PA-C

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1457920076
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2563 Issued in NV
Practice address
9480 Double Diamond Pkwy Ste 200
Reno, NV 89521-5842
Phone
(775) 348-8800
Fax
(833) 687-1419
NPI assigned
Jun 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA2563 NV
Physician Assistant 363A00000X PA2563 NV Primary

Addresses

Primary practice location

9480 Double Diamond Pkwy Ste 200
Reno, NV 89521-5842

Mailing address

5310 Kietzke LN Ste 104
Reno, NV 89511-2043
Phone (775) 348-8800

Other practice location 1

780 Vista Blvd Ste 100
Sparks, NV 89434-6677
Phone (775) 348-8800

Other practice location 2

1470 Medical Pkwy Ste 220
Carson City, NV 89703-4636
Phone (775) 348-8800

Other identifiers 2

IdentifierTypeStateIssuer
1457920076MedicaidNV
V71859OtherNVMEDICARE NV

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
I20220204001074 NV Practitioner - Physician Assistant 8426454950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James J Lynch M D LTDGroup PAC ID 9133188626, 81 clinicians

Practice addresses (Care Compare)

10539 Professional Cir
Suite 201
Reno, NV 89521-3858
Phone (775) 793-6190

1470 Medical Pkwy
Suite 220
Carson City, NV 89703-4647
Phone (775) 348-8800

2874 N Carson St
Suite 123
Carson City, NV 89706-1681
Phone (775) 783-6190

780 Vista Blvd
Suite 100
Sparks, NV 89434-6677
Phone (775) 348-8800

9480 Double Diamond Pkwy
Suite 200
Reno, NV 89521-5842
Phone (775) 348-8800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2563NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
James J Lynch MD LTD CurrentSince Mar 1, 2022 Accepting new patients
James J Lynch M D LTD CurrentSince Mar 1, 2022 Accepting new patients

Locations

1749 N Stewart St
Ste 50
Carson City, NV 89706
Phone (775) 392-3689

2874 N Carson St
Ste 123
Carson City, NV 89706

973 Mica Dr
Ste 201
Carson City, NV 89705
Phone (702) 884-5470

1470 Medical Pkwy
Ste 220
Carson City, NV 89703

2874 N Carson St
Ste 105
Carson City, NV 89706
Phone (775) 283-3321

825 S Meadows Pkwy
Ste 102
Reno, NV 89521

825 S Meadows Pkwy
Ste 103
Reno, NV 89521

10381 Double R Blvd
Reno, NV 89521
Phone (775) 322-1200

5310 Kietzke Ln
Ste 104
Reno, NV 89511

9990 Double R Blvd
Ste 200
Reno, NV 89521
Phone (753) 488-8008

595 Mount Rose St
Reno, NV 89509
Phone (775) 323-3660

1465 S Meadows Pkwy
Reno, NV 89521
Phone (775) 348-8885

9480 Double Diamond Pkwy
Ste 200
Reno, NV 89521
Phone (775) 348-8000

10539 Professional Cir
Ste 201
Reno, NV 89521
Phone (775) 674-5632

7700 Rancharrah Pkwy
Ste 100
Reno, NV 89511

780 Vista Blvd
Ste 100
Sparks, NV 89434
Phone (753) 348-8800

780 Vista Blvd
#101
Sparks, NV 89434

780 Vista Blvd
Ste 101
Sparks, NV 89434

Interoperability endpoints

  • Direct secure messaging: shanae.vizza.1@22724.direct.athenahealth.com

Organizations & group practices 2

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1457920076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 KIETZKE LN STE 104",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112043",
            "telephone_number": "775-348-8800",
            "fax_number": "833-687-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9480 DOUBLE DIAMOND PKWY STE 200",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215842",
            "telephone_number": "775-348-8800",
            "fax_number": "833-687-1419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 Vista Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sparks",
            "state": "NV",
            "postal_code": "894346677",
            "country_code": "US",
            "telephone_number": "775-348-8800",
            "fax_number": "833-687-1419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1470 Medical Pkwy Ste 220",
            "address_purpose": "LOCATION",
            "city": "Carson City",
            "state": "NV",
            "postal_code": "897034636",
            "country_code": "US",
            "telephone_number": "775-348-8800",
            "fax_number": "833-687-1419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIZZA",
        "first_name": "SHANAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA2563",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457920076",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NV",
            "identifier": "V71859",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.