Individual provider Active NPI

Susan R. Jimenez, NP, PA-C

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1871744748
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1868 Issued in NV
Practice address
8754 Steelhead CT
Reno, NV 89523-8948
Phone
(650) 556-4165
NPI assigned
Oct 9, 2008
Last updated
Mar 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15363 CA
Physician Assistant 363A00000X PA1868 NV Primary
Family Nurse Practitioner 363LF0000X 11392 CA

Addresses

Primary practice location

8754 Steelhead CT
Reno, NV 89523-8948

Mailing address

8754 Steelhead CT
Reno, NV 89523-8948

Other names 1

  • Ms. Susan R. Robinson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171123000008 NV Practitioner - Physician Assistant 1456618644 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11392CAMDChiropractor
PA1868NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Nevada HIV Outpatient Program, Education and Services CurrentSince Oct 4, 2023 Accepting new patients

Locations

580 W 5th St
Reno, NV 89503
Phone (775) 786-4673

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1871744748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8754 STEELHEAD CT",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895238948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8754 STEELHEAD CT",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895238948",
            "telephone_number": "650-556-4165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "SUSAN",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "NP, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-09",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "15363",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1868",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "11392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "ROBINSON",
            "middle_name": "R.",
            "prefix": "MS.",
            "credential": "NP, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.