Active NPI
Jessica Lynn Vlasek, PA-C
- Physician Assistant
- Reno, NV
National Provider Identifier
1770880361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2018
- Practice address
- 640 W Moana LN
Reno, NV 89509-4903 - Phone
- (775) 324-0699
- NPI assigned
- Feb 17, 2011
- Sex
- Female
- Sole proprietor
- No
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 | PA2018 | NV | Primary |
| Physician Assistant | 363A00000X | PA21455 | CA |
Addresses
Primary practice location
640 W Moana LN
Reno, NV 89509-4903
Mailing address
640 W Moana LN
Reno, NV 89509-4903
Phone (775) 324-0699
Other names 1
- Jessica Lynn Geddes
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA21455 | CA | MD | Physician Assistant |
| PA2018 | NV | MD | Physician Assistant |
| 21455 | CA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain West Derm-Blackhart, PLLC | Current | Accepting new patients | |
| Mountain West Derm - Blackhart PLLC | Current | Accepting new patients | |
| Skin Cancer and Dermatology Institute | Current | Accepting new patients |
Locations
3640 Warren Way
Ste 100
Reno, NV 89509
640 W Moana Ln
Reno, NV 89509
Phone (775) 882-8777
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 and National Provider Directory roles.
-
- MOHS-Micrographic Surgery Physician
- Reno, NV
- NPI 1740633015
-
- Dermatology Physician
- Danville, CA
- NPI 1093844292
-
- MOHS-Micrographic Surgery Physician
- Carson City, NV
- NPI 1003905001
-
- Dermatology Physician
- Tigard, OR
- NPI 1316656994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621987200000",
"number": "1770880361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 W MOANA LN",
"city": "RENO",
"state": "NV",
"postal_code": "895094903",
"telephone_number": "775-324-0699",
"fax_number": "775-323-6814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 W MOANA LN",
"city": "RENO",
"state": "NV",
"postal_code": "895094903",
"telephone_number": "775-324-0699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VLASEK",
"first_name": "JESSICA",
"middle_name": "LYNN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-17",
"last_updated": "2021-05-26",
"certification_date": "2021-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NV",
"license": "PA2018",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA21455",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "GEDDES",
"middle_name": "LYNN",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.