Peng MD PLLC

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

PENG MD PLLC

Doing business as

Amity Neurology

Practice address

500 Damonte Ranch Pkwy Ste 1030
Reno, NV 89521-5968

Phone

(775) 432-6189

Fax

(775) 284-5625

NPI assigned

May 15, 2019

Organization subpart

No

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

Authorized official

Name

Hsiaolin Fang

Title

Practice Manager

Phone

(217) 299-5892

Specialties & licenses 1

Addresses

Other names 1

• Amity Neurology Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laurie Macafee, APRN

  • Family Nurse Practitioner
  • Reno, NV
  • NPI 1912351107
  Medicare reassignment Care Compare group NPD
• Yen-Yi Peng, MD

  • Neurology Physician
  • Reno, NV
  • NPI 1891951638
  Medicare reassignment Care Compare group NPD
• Bobbi Lee Roth, FNP

  • Family Nurse Practitioner
  • Tualatin, OR
  • NPI 1558890848

  NV

  Medicare reassignment Care Compare group NPD
• Daria Ann Manha, APRN

  • Family Nurse Practitioner
  • Reno, NV
  • NPI 1649980079
  Medicare reassignment NPD

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1912563826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DAMONTE RANCH PKWY STE 1030",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215968",
            "telephone_number": "775-432-6189",
            "fax_number": "775-284-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DAMONTE RANCH PKWY STE 1030",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215968",
            "telephone_number": "775-432-6189",
            "fax_number": "775-284-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENG MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-15",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "FANG",
        "authorized_official_first_name": "HSIAOLIN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "217-299-5892"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amity Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Benjamin Tim Pence, D.O.
• William Pence, CADC-I
• Kami Leigh Pendergraft
• Eric Bruce Pendleton, D.D.S.
• Iulia Pendragon
• Yen-Yi Peng, MD
• Kaufononga Penitani
• Gabrielle Pennington
• Dallas R Penrod, D.P.M.
• Jason Penrod, PHARM D

• Community Health Clinic/Center in Reno, NV
• Providers in Reno, NV by specialty
• Community Health Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.