NPIMap

Individual provider Active NPI

Jennifer L Peters, PA-C

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1548591365
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1207 Issued in NV
Practice address
75 Pringle Way Ste 706
Reno, NV 89502-1472
Phone
(775) 982-3900
Fax
(775) 982-5000
NPI assigned
Jan 18, 2010
Last updated
May 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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
Physician Assistant 363A00000X PA1207 NV Primary

Addresses

Primary practice location

75 Pringle Way Ste 706
Reno, NV 89502-1472

Mailing address

1155 Mill St # M14
Reno, NV 89502-1576
Phone (775) 982-5000

Other practice location 1

3841 W Charleston Blvd Ste 201
Las Vegas, NV 89102-1858
Phone (702) 848-4443

Other names 1

  • Jennifer L Van Bogaert Former name

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
I20100429000638 NV Practitioner - Physician Assistant 8820049141 Reassigns benefits to 3 organizations
I20251017003826 CA Practitioner - Physician Assistant 8820049141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Stanford University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yang Medical Services PLLCGroup PAC ID 7315275773, 37 clinicians

Practice addresses (Care Compare)

1181 Grier Dr
Suite C
Las Vegas, NV 89119-3746
Phone (888) 888-9930

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC CurrentSince May 27, 2025 Accepting new patients
Carson Tahoe Emergency Physicians CurrentSince Nov 3, 2025 Accepting new patients
Community Care Services LLC CurrentSince May 27, 2025 Accepting new patients
Southern Mono Health Care District CurrentSince Aug 10, 2025 Accepting new patients
Community Care Services LLC Past Accepting new patients
True North Health Navigation LLC Past Accepting new patients
Saint Mary's Multi-Specialty Clinic, Inc. Past Accepting new patients

Locations

1600 Medical Pkwy
Carson City, NV 89703
Phone (775) 220-9149

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

1155 Mill St
#M14
Reno, NV 89502
Phone (775) 258-1970

75 Pringle Way
Ste 706
Reno, NV 89502
Phone (775) 784-5975

Interoperability endpoints

  • Direct secure messaging: jpeters158690@direct.renown.org

Organizations & group practices 9

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 5

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": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1548591365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST # M14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5000",
            "fax_number": "775-892-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PRINGLE WAY STE 706",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021472",
            "telephone_number": "775-982-3900",
            "fax_number": "775-982-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3841 W Charleston Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021858",
            "country_code": "US",
            "telephone_number": "702-848-4443",
            "fax_number": "720-598-0440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-18",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "VAN BOGAERT",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.