NPIMap

Individual provider Active NPI

Andrew V Pasternak IV, MD

  • Family Medicine Physician
  • Reno, NV
National Provider Identifier
1689605214
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8674 Issued in NV
Practice address
10467 Double R Blvd
Reno, NV 89521-8905
Phone
(775) 853-9394
Fax
(775) 853-3339
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8674 NV Primary

Addresses

Primary practice location

10467 Double R Blvd
Reno, NV 89521-8905

Mailing address

10467 Double R Blvd
Reno, NV 89521-8905
Phone (775) 853-9394

Other identifiers 1

IdentifierTypeStateIssuer
002016285MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050131000847 NV Practitioner - Family Practice 6305896929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Silver Sage Center for Family MedicineGroup PAC ID 1557379385, 3 clinicians

Practice addresses (Care Compare)

10467 Double R Blvd
Reno, NV 89521-8905
Phone (775) 853-9394

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8674NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Sage Center for Family Medicine Family Medicine CurrentSince Feb 1, 2005 Accepting new patients
Mt Grant General Hospital Past Accepting new patients
Renown Regional Medical Center Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients

Locations

10467 Double R Blvd
Reno, NV 89521
Phone (775) 853-6390

Interoperability endpoints

  • Direct secure messaging: andrew.pasternak@477601064878084.direct.elationemr.com
  • Direct secure messaging: admin@silversage.e-mdsdirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689605214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10467 DOUBLE R BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895218905",
            "telephone_number": "775-853-9394",
            "fax_number": "775-853-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10467 DOUBLE R BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895218905",
            "telephone_number": "775-853-9394",
            "fax_number": "775-853-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTERNAK",
        "first_name": "ANDREW",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "8674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002016285",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.