Active NPI
William Toru Miyazaki, D.O.
- Family Medicine Physician
- Reno, NV
National Provider Identifier
1609904507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 447
- Practice address
- 5990 Silver Lake Rd
Reno, NV 89506-2301 - Phone
- (775) 972-9100
- Fax
- (775) 972-9101
- NPI assigned
- Mar 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5017 | CA | |
| Family Medicine Physician | 207Q00000X | 447 | NV | Primary |
Addresses
Primary practice location
5990 Silver Lake Rd
Reno, NV 89506-2301
Mailing address
5990 Silver Lake Rd
Reno, NV 89506-2301
Phone (775) 972-9100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11864 | Other | NV | ANTHEM BLUE CROSS |
| CC3139 | Other | NV | FEDERAL BLUE CROSS |
| 002016018 | Medicaid | NV |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101021000972 | NV | Practitioner - Family Practice | 8921291014 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5017 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659916800000",
"number": "1609904507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5990 SILVER LAKE RD",
"city": "RENO",
"state": "NV",
"postal_code": "895062301",
"telephone_number": "775-972-9100",
"fax_number": "775-972-9101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5990 SILVER LAKE RD",
"city": "RENO",
"state": "NV",
"postal_code": "895062301",
"telephone_number": "775-972-9100",
"fax_number": "775-972-9101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIYAZAKI",
"first_name": "WILLIAM",
"middle_name": "TORU",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-01",
"last_updated": "2022-08-08",
"certification_date": "2022-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "5017",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "447",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "11864",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL BLUE CROSS",
"identifier": "CC3139",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002016018",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.