Active NPI
Reno Tsosie
- Physician Assistant
- Fort Defiance, AZ
National Provider Identifier
1730865577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2024-0137
- Practice address
- Corner of Route N12 and N7
Fort Defiance, AZ 86504 - Phone
- (928) 729-8000
- NPI assigned
- Jun 26, 2023
- Last updated
- Nov 25, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2024-0137 | NM | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
Corner of Route N12 and N7
Fort Defiance, AZ 86504
Mailing address
PO Box 649
Fort Defiance, AZ 86504-0649
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
Corner of Route N12 and N7
Fdihb Inc.
Fort Defiance, AZ 86504-0649
Phone (928) 729-8082
PO Box
Suite 649
Fort Defiance, AZ 86504-0649
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Fort Defiance Indian Hospital
- General Acute Care Hospital
- Fort Defiance, AZ
- NPI 1477876639
TX
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732492800000",
"number": "1730865577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 649",
"city": "FORT DEFIANCE",
"state": "AZ",
"postal_code": "865040649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CORNER OF ROUTE N12 AND N7",
"city": "FORT DEFIANCE",
"state": "AZ",
"postal_code": "86504",
"telephone_number": "928-729-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TSOSIE",
"first_name": "RENO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-26",
"last_updated": "2024-11-25",
"certification_date": "2024-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NM",
"license": "PA2024-0137",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Defiance, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.