NPIMap

Individual provider Active NPI

Ivy T Spadone, PA-C

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1750475703
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA628 Issued in NV
Practice address
580 W 5TH St
Reno, NV 89503-4407
Phone
(775) 786-4673
Fax
(775) 348-2889
NPI assigned
Oct 3, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 PA628 NV Primary

Addresses

Primary practice location

580 W 5TH St
Reno, NV 89503-4407

Mailing address

580 W 5TH St
Reno, NV 89503-4407
Phone (775) 786-4673

Other identifiers 1

IdentifierTypeStateIssuer
970028739OtherNVRAILROAD MEDICARE

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
I20051101001183 NV Practitioner - Physician Assistant 0446277065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

580 W 5TH St
Reno, NV 89503-4407
Phone (775) 786-4673

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA628NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Springs CurrentSince Feb 1, 2007 Accepting new patients
Northern Nevada HIV Outpatient Program, Education and Services Past Accepting new patients
Renown Urgent Care LLC Physician Assistant Past Accepting new patients

Locations

580 W 5th St
Reno, NV 89503
Phone (775) 786-4673

Interoperability endpoints

  • Direct secure messaging: ivy.spadone@nnhopes.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Northern Nevada HopesReno, NV, CCN 291847 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Nov 1, 2013
Nov 1, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750475703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 W 5TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034407",
            "telephone_number": "775-786-4673",
            "fax_number": "775-348-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W 5TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034407",
            "telephone_number": "775-786-4673",
            "fax_number": "775-348-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPADONE",
        "first_name": "IVY",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970028739",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.