NPIMap

Individual provider Active NPI

Garrett M Fidalgo, MD

  • Emergency Medicine Physician
  • Reno, NV
National Provider Identifier
1811283427
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
15261 Issued in NV
Practice address
235 W 6TH St
Reno, NV 89503-4548
Phone
(775) 770-3188
NPI assigned
Jun 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN16307 FL
Emergency Medicine Physician 207P00000X 15261 NV Primary

Addresses

Primary practice location

235 W 6TH St
Reno, NV 89503-4548

Mailing address

5420 Kietzke LN
Suite 105
Reno, NV 89511-3022
Phone (775) 770-3188

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
I20150522000949 NV Practitioner - Emergency Medicine 4486899697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Vermont College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reno Emergency Physicians Association PLLCGroup PAC ID 6305745738, 13 clinicians

Practice addresses (Care Compare)

235 W 6TH St
Reno, NV 89503-4548
Phone (775) 770-5188

Hospital & facility affiliations

  • Saint Mary'S Regional Medical Center Hospital, Reno, NV, CCN 290009
  • Northern Nevada Medical Center Hospital, Sparks, NV, CCN 290032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN16307FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Nevada Emergency Physicians PLLC Emergency Medicine Current Accepting new patients
Reno Emergency Physicians Association, PLLC Emergency Medicine CurrentSince Jan 27, 2015 Accepting new patients

Locations

6500 Longley Ln
Reno, NV 89511
Phone (775) 331-7000

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

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 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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1811283427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 KIETZKE LN",
            "address_2": "SUITE 105",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113022",
            "telephone_number": "775-770-3188",
            "fax_number": "775-853-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 W 6TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034548",
            "telephone_number": "775-770-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDALGO",
        "first_name": "GARRETT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN16307",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "15261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.