NPIMap

Individual provider Active NPI

Amanda Wong

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1497307763
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2388 Issued in NV
Practice address
901 E 2ND St Ste 300
Reno, NV 89502-1175
Phone
(775) 982-5000
Fax
(775) 982-3901
NPI assigned
Jul 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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 PA59545 CA
Physician Assistant 363A00000X PA2388 NV Primary

Addresses

Primary practice location

901 E 2ND St Ste 300
Reno, NV 89502-1175

Mailing address

1155 Mill St # Msm14
Reno, NV 89502-1576
Phone (775) 982-5262

Other identifiers 2

IdentifierTypeStateIssuer
PA59545OtherCACALIFORNIA PA LICENSE
PA2388OtherNVNEVADA PA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210118000145 NV Practitioner - Physician Assistant 8628481413 Reassigns benefits to 3 organizations
I20210805002467 CA Practitioner - Physician Assistant 8628481413

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nevada School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians
Mariko C Rajamand PLLCGroup PAC ID 4385016435, 8 clinicians

Practice addresses (Care Compare)

10101 Double R Blvd
Reno, NV 89521-5931
Phone (775) 982-7878

5448 Reno Corporate Dr
Reno, NV 89511-2620
Phone (775) 993-9292

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
79.09
Promoting interoperability
100
Improvement activities
40
Cost
71.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59545CAMDPharmacist
PA59545CAMDPhysician Assistant
PA2388NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC Physician Assistant CurrentSince Sep 18, 2024 Accepting new patients
Community Care Services LLC CurrentSince Sep 18, 2024 Accepting new patients
Community Care Services LLC Past Accepting new patients

Locations

10085 Double R Blvd
Ste 120
Reno, NV 89521
Phone (775) 982-4910

901 E 2nd St
Ste 300
Reno, NV 89502
Phone (775) 982-5640

1155 Mill St
#14
Reno, NV 89502

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

Interoperability endpoints

  • Direct secure messaging: awong208252@direct.renown.org

Organizations & group practices 6

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 2

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": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1497307763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST # MSM14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E 2ND ST STE 300",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021175",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59545",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA PA LICENSE",
            "identifier": "PA59545",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA PA LICENSE",
            "identifier": "PA2388",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.