NPIMap

Organization Active NPI

Sutter Bay Medical Foundation

  • Nephrology Physician
  • Las Vegas, NV
National Provider Identifier
1679924765
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
SUTTER BAY MEDICAL FOUNDATION
Practice address
3006 S Maryland Pkwy Ste 470
Las Vegas, NV 89109-2235
Phone
(702) 796-9111
Fax
(702) 792-9112
NPI assigned
Jun 29, 2016
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kristin Keller
Title
Sr. Director, Planning and Alignmen
Phone
(650) 934-7000

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20140609001793 NV Part B Supplier - Clinic/Group Practice 4284538778 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Henderson, NV; Reno, NV; Las Vegas, NV

National Provider Directory

National Provider Directory
Tax ID family
Sutter Bay Medical Found (35 organizations share this tax ID)

Locations

850 Mill St
Ste 201
Reno, NV 89502
Phone (775) 829-7600

670 Sierra Rose Dr
Reno, NV 89511
Phone (702) 796-9111

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Hepatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0008X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

NPPES NPI Registry

Primary practice location

3006 S Maryland Pkwy Ste 470
Las Vegas, NV 89109-2235

Mailing address

PO Box 276950
Sacramento, CA 95827-6950

Other names 1

NPPES NPI Registry
  • Sutter Pacific Medical Foundation Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 18, 2026.

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773792000000",
    "number": "1679924765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 276950",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958276950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 S MARYLAND PKWY STE 470",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092235",
            "telephone_number": "702-796-9111",
            "fax_number": "702-792-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER BAY MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-29",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "SR. DIRECTOR, PLANNING AND ALIGNMEN",
        "authorized_official_telephone_number": "650-934-7000"
    },
    "taxonomies": [
        {
            "code": "207RI0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hepatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutter Pacific Medical Foundation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sutter Pacific Medical Foundation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.