Individual provider Active NPI

Mikayla S McEntire, PA-C

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1669123527
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3119 Issued in NV
Practice address
75 Pringle Way Ste 401
Reno, NV 89502-1476
Phone
(775) 982-2970
Fax
(775) 982-2973
NPI assigned
Jan 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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 PA3119 NV Primary

Addresses

Primary practice location

75 Pringle Way Ste 401
Reno, NV 89502-1476

Mailing address

1155 Mill St # M14
Reno, NV 89502-1576
Phone (775) 982-2970

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
I20260121002768 NV Practitioner - Physician Assistant 7012494016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1155 Mill St
Reno, NV 89502-1576

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA3119NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
A3 Rajamand PLLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

3080 Vista Blvd
Ste 100
Sparks, NV 89436
Phone (775) 250-2233

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1669123527",
    "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": "775-982-2970",
            "fax_number": "775-982-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PRINGLE WAY STE 401",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021476",
            "telephone_number": "775-982-2970",
            "fax_number": "775-982-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCENTIRE",
        "first_name": "MIKAYLA",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-12",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA3119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.