Individual provider Active NPI

Robert John Nachtsheim, MD

  • Surgery Physician
  • Reno, NV
National Provider Identifier
1962490193
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
11528 Issued in NV
Practice address
1500 E 2ND St
Suite 206
Reno, NV 89502-1181
Phone
(775) 789-7000
Fax
(775) 789-7040
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 11528 NV Primary

Addresses

Primary practice location

1500 E 2ND St
Suite 206
Reno, NV 89502-1181

Mailing address

1500 E 2ND St
Ste 206
Reno, NV 89502-1198
Phone (775) 789-7050

Other practice location 1

380 Chase Ave
Walla Walla, WA 99362-2924
Phone (509) 897-3790

Other identifiers 3

IdentifierTypeStateIssuer
100506936MedicaidNV
CC0919OtherBCBS
CC0919OtherNVANTHEM BCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rnachtsheim1254642@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210331001202 WA Practitioner - General Surgery 9133159221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Nevada School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services - WashingtonGroup PAC ID 2860552973, 266 clinicians

Practice addresses (Care Compare)

401 W Poplar St
Walla Walla, WA 99362-2846
Phone (509) 897-3320

Hospital & facility affiliations

  • Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11528NVMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Washington Surgery CurrentSince Dec 20, 2020 Accepting new patients
Providence Health & Services - Washington CurrentSince Dec 20, 2020 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

401 W Poplar St
Walla Walla, WA 99362
Phone (509) 522-5731

380 Chase Ave
Walla Walla, WA 99362
Phone (509) 526-3333

Interoperability endpoints

  • Direct secure messaging: rnachtsheim1254642@wm.providencedirect.org

Organizations & group practices 3

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 1

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1962490193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E 2ND ST",
            "address_2": "STE 206",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021198",
            "telephone_number": "775-789-7050",
            "fax_number": "775-789-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E 2ND ST",
            "address_2": "SUITE 206",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021181",
            "telephone_number": "775-789-7000",
            "fax_number": "775-789-7040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 Chase Ave",
            "address_purpose": "LOCATION",
            "city": "Walla Walla",
            "state": "WA",
            "postal_code": "993622924",
            "country_code": "US",
            "telephone_number": "509-897-3790",
            "fax_number": "509-897-5558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NACHTSHEIM",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "11528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506936",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "CC0919",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "CC0919",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rnachtsheim1254642@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "380 Chase Ave",
            "city": "Walla Walla",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993622924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.