NPIMap

Individual provider Active NPI

Keely Chevallier, M.D.

  • Otolaryngology Physician
  • Reno, NV
National Provider Identifier
1780973354
Registry record updated Jun 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
8405870 Issued in UT
Practice address
9770 S McCarran Blvd
Reno, NV 89523-9203
Phone
(775) 322-4589
NPI assigned
Apr 4, 2011
Last updated
Jun 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 19794 NV
Otolaryngology Physician 207Y00000X 8405870 UT Primary

Addresses

Primary practice location

9770 S McCarran Blvd
Reno, NV 89523-9203

Mailing address

9770 S McCarran Blvd
Reno, NV 89523-9203
Phone (775) 322-4589

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
I20200619000639 NV Practitioner - Otolaryngology 7113159278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Colorado School of Medicine, Denver, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nevada ENT and Hearing Associates LLCGroup PAC ID 7012169139, 6 clinicians

Practice addresses (Care Compare)

9770 S McCarran Blvd
Reno, NV 89523-9203
Phone (775) 322-4589

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.54 of 100Reported as group
Quality
83.09
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19794NVMDOtolaryngology Physician
8405870UTMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nevada ENT & Hearing Associates LLC Otolaryngology CurrentSince Aug 3, 2020 Accepting new patients
Renown Regional Medical Center Past Accepting new patients
South Lyon Health Center, Inc. Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
Mt Grant General Hospital Past Accepting new patients

Locations

9770 S McCarran Blvd
Reno, NV 89523
Phone (775) 284-8511

Organizations & group practices 6

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 9

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": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592006400000",
    "number": "1780973354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9770 S MCCARRAN BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895239203",
            "telephone_number": "775-322-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9770 S MCCARRAN BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895239203",
            "telephone_number": "775-322-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEVALLIER",
        "first_name": "KEELY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2020-06-13",
        "certification_date": "2020-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NV",
            "license": "19794",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "8405870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.