Individual provider Active NPI

John K Kilonzo, PA-C

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1851116149
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3177 Issued in NV
Practice address
75 Pringle Way Ste 900
Reno, NV 89502-1464
Phone
(775) 982-6270
Fax
(775) 982-6271
NPI assigned
Nov 20, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA3177 NV Primary

Addresses

Primary practice location

75 Pringle Way Ste 900
Reno, NV 89502-1464

Mailing address

1155 Mill St # M14
Reno, NV 89502-1576
Phone (775) 982-6270

Other identifiers 2

IdentifierTypeStateIssuer
PA3177OtherNVPAC NUMBER
16454624OtherNVCAQH NUMBER

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250527002981 NV Practitioner - Physician Assistant 3375062920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians

Practice addresses (Care Compare)

10101 Double R Blvd
Reno, NV 89521-5931
Phone (775) 982-7878

1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-4000

1343 Newlands Dr W
Fernley, NV 89408-8926
Phone (775) 982-5000

75 Pringle Way
Reno, NV 89502-1464

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA3177NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC CurrentSince May 14, 2025 Accepting new patients
Community Care Services LLC CurrentSince May 14, 2025 Accepting new patients
Community Care Services LLC Past Accepting new patients

Locations

1155 Mill St
#M14
Reno, NV 89502
Phone (775) 258-1970

75 Pringle Way
Ste 900
Reno, NV 89502
Phone (775) 982-6270

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

Interoperability endpoints

  • Direct secure messaging: jkilonzo147214@direct.renown.org

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 3

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": "1732060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1851116149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST # M14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-6270",
            "fax_number": "775-982-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PRINGLE WAY STE 900",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021464",
            "telephone_number": "775-982-6270",
            "fax_number": "775-982-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILONZO",
        "first_name": "JOHN",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-20",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA3177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PAC NUMBER",
            "identifier": "PA3177",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "16454624",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.