Individual provider Active NPI

Troy Eden, P.A.

  • Physician Assistant
  • Elko, NV
National Provider Identifier
1528122777
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1026 Issued in NV
Practice address
762 14TH St
Elko, NV 89801-3413
Phone
(702) 240-6482
Fax
(702) 240-8529
NPI assigned
Dec 21, 2006
Last updated
Dec 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1026 NV Primary

Addresses

Primary practice location

762 14TH St
Elko, NV 89801-3413

Mailing address

700 E Silverado Ranch Blvd Ste 170
Las Vegas, NV 89183-7518
Phone (702) 240-6482

Other practice location 1

845 Railroad St
Elko, NV 89801-3831
Phone (775) 753-3770

Other identifiers 2

IdentifierTypeStateIssuer
V105461OtherNVEDEN MEDICAL PTAN
V105503OtherNVTROY'S PTAN

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
I20080304000748 NV Practitioner - Physician Assistant 9335136738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
AemsGroup PAC ID 4789939125, 7 clinicians

Practice addresses (Care Compare)

250 Country Club Pkwy
Spring Creek, NV 89815-5830
Phone (775) 738-3000

2511 Mountain City Hwy
Elko, NV 89801-4496
Phone (775) 993-2800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA1026NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clovis Medical Associates LLC PastSince Apr 30, 2003 Accepting new patients
First Choice Physical Therapy Past Accepting new patients

Organizations & group practices 3

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 1

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1528122777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E SILVERADO RANCH BLVD STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891837518",
            "telephone_number": "702-240-6482",
            "fax_number": "702-804-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 14TH ST",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898013413",
            "telephone_number": "702-240-6482",
            "fax_number": "702-240-8529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "845 Railroad St",
            "address_purpose": "LOCATION",
            "city": "Elko",
            "state": "NV",
            "postal_code": "898013831",
            "country_code": "US",
            "telephone_number": "775-753-3770",
            "fax_number": "775-753-3772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDEN",
        "first_name": "TROY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDEN MEDICAL PTAN",
            "identifier": "V105461",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TROY'S PTAN",
            "identifier": "V105503",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, NV

Sources for this page

Verify at the official NPI Registry.