Individual provider Active NPI

Kenneth W Pitman, M.D.

  • Specialist
  • Reno, NV
National Provider Identifier
1790716652
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
5263 Issued in NV
Practice address
605 Sierra Rose Dr
Suite 4
Reno, NV 89511-2060
Phone
(775) 689-5410
Fax
(775) 689-5431
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 5263 NV Primary

Addresses

Primary practice location

605 Sierra Rose Dr
Suite 4
Reno, NV 89511-2060

Mailing address

605 Sierra Rose Dr
Suite 4
Reno, NV 89511-2060
Phone (775) 689-5410

Other identifiers 2

IdentifierTypeStateIssuer
NV9242OtherNVBLUE CROSS BLUE SHIELD
050057643OtherNVRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070115000349 NV Practitioner - AnesthesiologyPractitioner - Pain Management 3173583317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.11 of 100Reported as group
Quality
72.21
Improvement activities
40
Cost
83.57

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michael H Song MD LTD CurrentSince Apr 28, 2024 Accepting new patients
Michael H Song MD LTD CurrentSince Apr 28, 2024 Accepting new patients
Picetti LTD PastSince Apr 30, 2003 Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients

Locations

1470 Medical Pkwy
Ste 240
Carson City, NV 89703
Phone (775) 323-6100

2098 Idaho St
Elko, NV 89801
Phone (775) 323-6100

10791 Double R Blvd
Reno, NV 89521
Phone (775) 284-2020

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

235 W 6th St
Reno, NV 89503
Phone (775) 746-3202

2375 E Prater Way
Sparks, NV 89434
Phone (775) 331-7000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1790716652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 SIERRA ROSE DR",
            "address_2": "SUITE 4",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112060",
            "telephone_number": "775-689-5410",
            "fax_number": "775-689-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 SIERRA ROSE DR",
            "address_2": "SUITE 4",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112060",
            "telephone_number": "775-689-5410",
            "fax_number": "775-689-5431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITMAN",
        "first_name": "KENNETH",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "5263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NV9242",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050057643",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.