Reno Family Medical Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

11950 Issued in NV

Legal business name

RENO FAMILY MEDICAL CLINIC

Practice address

1699 S Virginia St
Suite 100
Reno, NV 89502-2820

Phone

(775) 742-7028

Fax

(775) 786-8685

NPI assigned

Mar 27, 2014

Organization subpart

No

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

Authorized official

Name

Mary Ann Pettit

Title

Credentialing

Phone

(888) 737-3720

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Reno Family Medical Clinic, LLC Other name

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohsen Tamasaby, MD

  • Adult Medicine Physician
  • Reno, NV
  • NPI 1235242470
  Medicare reassignment NPD

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539820800000",
    "number": "1477970325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 S VIRGINIA ST",
            "address_2": "SUITE 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022820",
            "telephone_number": "775-742-7028",
            "fax_number": "775-786-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 S VIRGINIA ST",
            "address_2": "SUITE 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022820",
            "telephone_number": "775-742-7028",
            "fax_number": "775-786-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENO FAMILY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-27",
        "last_updated": "2018-10-18",
        "status": "A",
        "authorized_official_last_name": "PETTIT",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "888-737-3720"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NV",
            "license": "11950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235242470",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reno Family Medical Clinic, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Reno Family Medical Clinic, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Reno Foot & Ankle Institute LLC
• Reno Geriatrics LLC
• Reno Hand Center, LTD
• Reno Health Care LLC (Sierra Ridge Health and Wellness Suites)

• Primary Care Clinic/Center in Reno, NV
• Providers in Reno, NV by specialty
• Primary Care Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; 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.