Individual provider Active NPI

Sarah Elizabeth Gutierrez, PA-C

  • Medical Physician Assistant
  • Reno, NV
National Provider Identifier
1528495173
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA1632 Issued in NV
Practice address
975 Ryland St Ste 100
Reno, NV 89502-1669
Phone
(775) 982-5000
Fax
(775) 982-5225
NPI assigned
Sep 27, 2013
Last updated
Jun 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA1632 NV Primary

Addresses

Primary practice location

975 Ryland St Ste 100
Reno, NV 89502-1669

Mailing address

850 Harvard Way
Reno, NV 89502-2055
Phone (775) 982-5262

Other identifiers 2

IdentifierTypeStateIssuer
13620814OtherNVCAQH
PA1632OtherNVPA-C LICENSE

Other names 1

  • Ms. Sarah Duclos Former name

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
I20150922002287 NV Practitioner - Physician Assistant 4587894787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3640 Warren Way
Reno, NV 89509-5240
Phone (775) 324-0699

4814 Sparks Blvd
Sparks, NV 89436-8219
Phone (775) 324-0699

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Cancer and Dermatology Institute Current Accepting new patients
Mountain West Derm-Blackhart, PLLC CurrentSince Oct 1, 2019 Accepting new patients
Mountain West Derm - Blackhart PLLC CurrentSince Oct 1, 2019 Accepting new patients
Washoe Barton Medical Clinic a Nevada Nonprofit Corporation Past Accepting new patients
Dermatology Associates,P.C. Past Accepting new patients

Locations

3640 Warren Way
Ste 100
Reno, NV 89509

640 W Moana Ln
Reno, NV 89509
Phone (775) 882-8777

4814 Sparks Blvd
Sparks, NV 89436
Phone (753) 240-6997

Organizations & group practices 5

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 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": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1528495173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARVARD WAY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022055",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 RYLAND ST STE 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021669",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-27",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA1632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13620814",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA-C LICENSE",
            "identifier": "PA1632",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "DUCLOS",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.