Individual provider Active NPI

Serena Lee

  • Medical Physician Assistant
  • Reno, NV
National Provider Identifier
1871167916
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA2676 Issued in NV
Practice address
160 Country Estates Cir Ste 2
Reno, NV 89511-4018
Phone
(775) 322-9100
NPI assigned
May 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X PA2676 NV Primary

Addresses

Primary practice location

160 Country Estates Cir Ste 2
Reno, NV 89511-4018

Mailing address

160 Country Estates Cir Ste 2
Reno, NV 89511-4018
Phone (775) 322-9100

Other practice location 1

1310 Club Dr
Vallejo, CA 94592-1187
Phone (707) 638-5809

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
I20221019002917 NV Practitioner - Physician Assistant 0042686867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bachman and Scully, LTD.Group PAC ID 1850302902, 4 clinicians

Practice addresses (Care Compare)

160 Country Estate Circle
Reno, NV 89511-4040

160 Country Estates Circle
Suite 2
Reno, NV 89511-4040
Phone (775) 322-9100

Hospital & facility affiliations

  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
  • Banner Lassen Medical Center Hospital, Susanville, CA, CCN 051320
  • Eastern Plumas Hospital - Portola Campus Hospital, Portola, CA, CCN 051300

National Provider Directory

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

Organizations & group practices 1

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 5

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": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1871167916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 COUNTRY ESTATES CIR STE 2",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895114018",
            "telephone_number": "775-322-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 COUNTRY ESTATES CIR STE 2",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895114018",
            "telephone_number": "775-322-9100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 Club Dr",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945921187",
            "country_code": "US",
            "telephone_number": "707-638-5809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SERENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-13",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA2676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.