NPIMap

Individual provider Active NPI

Cory Charles Wilcox, PA-C

  • Surgical Physician Assistant
  • Reno, NV
National Provider Identifier
1770143356
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
555 N Arlington Ave
Reno, NV 89503-4723
Phone
(775) 786-3040
Fax
(775) 788-5235
NPI assigned
Jun 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

555 N Arlington Ave
Reno, NV 89503-4723

Mailing address

555 N Arlington Ave
Reno, NV 89503-4723
Phone (775) 786-3040

Other identifiers 2

IdentifierTypeStateIssuer
14948847OtherCAQH
1770143356MedicaidNV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cwilcox163013@Direct.renown.org

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
I20201012000186 NV Practitioner - Physician Assistant 8921428012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nevada School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Custom Physical Therapy Limited PartnershipGroup PAC ID 1355252842, shared by 2 NPIs, 76 clinicians
Reno Orthopaedic Clinic LTDGroup PAC ID 2567355316, 96 clinicians

Practice addresses (Care Compare)

440 E Golden Valley Rd
Suite Aandb
Reno, NV 89506-5722
Phone (775) 360-3000

555 N Arlington Ave
Reno, NV 89503-4723
Phone (775) 786-3040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.71 of 100Reported as apm
Quality
81.42
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reno Orthopaedic Clinic, LTD CurrentSince Oct 2, 2020 Accepting new patients
Reno Orthopaedic Clinic, LTD CurrentSince Oct 2, 2020 Accepting new patients
Reno Orthopaedic Clinic, LTD Past Accepting new patients

Locations

555 N Arlington Ave
Reno, NV 89503

Interoperability endpoints

  • Direct secure messaging: cwilcox163013@direct.renown.org
  • Direct secure messaging: cwilcox479552@direct.med.utah.edu

Organizations & group practices 3

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 6

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": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1770143356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N ARLINGTON AVE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034723",
            "telephone_number": "775-786-3040",
            "fax_number": "775-786-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N ARLINGTON AVE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034723",
            "telephone_number": "775-786-3040",
            "fax_number": "775-788-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "CORY",
        "middle_name": "CHARLES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14948847",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770143356",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwilcox163013@Direct.renown.org",
            "affiliation": "N",
            "address_1": "555 N Arlington Ave",
            "city": "Reno",
            "state": "NV",
            "country_code": "US",
            "postal_code": "895034723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.