Individual provider Active NPI

Kari Jordan Rezac, DO

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Truckee, CA
National Provider Identifier
1811459043
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
20A21020 Issued in CA
Practice address
10710 Donner Pass Rd
Truckee, CA 96161-4812
Phone
(530) 582-7488
NPI assigned
Apr 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 20A21020 CA Primary

Addresses

Primary practice location

10710 Donner Pass Rd
Truckee, CA 96161-4812

Mailing address

10710 Donner Pass Rd
Truckee, CA 96161-4812
Phone (530) 582-7488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240920002481 CA Practitioner - Sports MedicinePractitioner - Physical Medicine and Rehabilitation 4284962598 Reassigns benefits to 1 organization
I20260219004423 NV Practitioner - Physical Medicine and Rehabilitation 4284962598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Lake Erie College of Osteopathic Medicine, Erie, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

880 Alder Ave
Incline Village, NV 89451-8335

PO Box
Suite 60901
Truckee, CA 96160

Hospital & facility affiliations

  • Tahoe Forest Hospital Hospital, Truckee, CA, CCN 051328
  • Incline Village Community Hospital Hospital, Incline Village, NV, CCN 291301

Merit-based Incentive Payment System (MIPS)

Final score
75.06 of 100Reported as group
Quality
83.97
Promoting interoperability
88
Improvement activities
40
Cost
42.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A21020CAMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tahoe Forest Hospital District CurrentSince Sep 1, 2024 Accepting new patients
Tahoe Forest Hospital District CurrentSince Dec 1, 2025 Accepting new patients
Tahoe Forest Hospital District CurrentSince Sep 1, 2024 Accepting new patients
Tahoe Forest Hospital District Current Accepting new patients

Locations

10051 Lake Ave
Ste 3
Truckee, CA 96161
Phone (530) 587-7461

10710 Donner Pass Rd
Truckee, CA 96161
Phone (530) 582-7488

10710 Donner Pass Rd
Fl 2
Truckee, CA 96161
Phone (530) 582-7488

10121 Pine Ave
Truckee, CA 96161
Phone (530) 582-3220

880 Alder Ave
Incline Vlg, NV 89451
Phone (775) 831-6200

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.

Hospital & facility affiliations 2

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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1811459043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 DONNER PASS RD",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614812",
            "telephone_number": "530-582-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 DONNER PASS RD",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614812",
            "telephone_number": "530-582-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZAC",
        "first_name": "KARI",
        "middle_name": "JORDAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "20A21020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Truckee, CA

Sources for this page

Verify at the official NPI Registry.