Individual provider Active NPI

Shaina Marissa Willen, MD

  • Pediatric Pulmonology Physician
  • Reno, NV
National Provider Identifier
1730479627
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
29058 Issued in NV
Practice address
1155 Mill St
Reno, NV 89502-1576
Phone
(775) 982-5123
Fax
(775) 982-5470
NPI assigned
Apr 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 29058 NV Primary
Pediatric Hematology & Oncology Physician 2080P0207X A159074 CA
Pediatrics Physician 208000000X A159074 CA

Addresses

Primary practice location

1155 Mill St
Reno, NV 89502-1576

Mailing address

1155 Mill St # Msm14
Reno, NV 89502-1576
Phone (775) 982-5262

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191120001411 CA Practitioner - Pulmonary DiseasePractitioner - Pediatric MedicinePractitioner - Hematology 2062637101 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A159074CAMDPediatrics Physician
29058NVMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Dec 15, 2021 Accepting new patients
Barton Medical Foundation CurrentSince Dec 10, 2025 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Dec 15, 2021 Accepting new patients
Tahoe Carson Valley Medical Group Inc Pediatrics CurrentSince Sep 18, 2019 Accepting new patients

Locations

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

2521 Stockton Blvd
Fl 3
Sacramento, CA 95817
Phone (916) 734-2781

2175 South Ave
South Lake Tahoe, CA 96150
Phone (530) 543-5711

2074 Lake Tahoe Blvd
Ste 4
South Lake Tahoe, CA 96150
Phone (530) 543-5554

2170 South Ave
South Lake Tahoe, CA 96150
Phone (530) 541-3420

1090 3rd St
South Lake Tahoe, CA 96150
Phone (530) 543-5660

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

1155 Mill St
#14
Reno, NV 89502

Interoperability endpoints

  • Direct secure messaging: swillen149099@direct.renown.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1730479627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST # MSM14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 MILL ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5123",
            "fax_number": "775-982-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEN",
        "first_name": "SHAINA",
        "middle_name": "MARISSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NV",
            "license": "29058",
            "primary": true
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "CA",
            "license": "A159074",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A159074",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.