Individual provider Active NPI

Emily Reus Bevan, MD

  • Obstetrics & Gynecology Physician
  • Truckee, CA
National Provider Identifier
1972867570
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD6064414 Issued in WA
Practice address
10121 Pine Ave FL 2
Truckee, CA 96161-4856
Phone
(530) 587-1041
NPI assigned
Jun 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD6064414 WA Primary

Addresses

Primary practice location

10121 Pine Ave FL 2
Truckee, CA 96161-4856

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other practice location 1

751 NE Blakely Dr Ste 230
Issaquah, WA 98029-6201
Phone (425) 313-7080

Other identifiers 1

IdentifierTypeStateIssuer
2065249MedicaidWA

Other names 1

  • Emily S Reus Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ereus1043049@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240916003089 CA Practitioner - Obstetrics/Gynecology 4486886553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tahoe Forest Hospital DistrictGroup PAC ID 0446161335, 140 clinicians

Practice addresses (Care Compare)

10121 Pine Ave
Truckee, CA 96161-4835
Phone (530) 587-6011

Hospital & facility affiliations

  • Tahoe Forest Hospital Hospital, Truckee, CA, CCN 051328

Merit-based Incentive Payment System (MIPS)

Final score
87.1 of 100Reported as group
Quality
84.53
Promoting interoperability
100
Improvement activities
40
Cost
72.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD6064414WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tahoe Forest Hospital District Current Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

10121 Pine Ave
Truckee, CA 96161
Phone (530) 582-3220

10121 Pine Ave
Fl 2
Truckee, CA 96161
Phone (530) 582-6368

Interoperability endpoints

  • Direct secure messaging: ereus1043049@wm.providencedirect.org

Organizations & group practices 2

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": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1972867570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10121 PINE AVE FL 2",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614856",
            "telephone_number": "530-587-1041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 NE Blakely Dr Ste 230",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980296201",
            "country_code": "US",
            "telephone_number": "425-313-7080",
            "fax_number": "425-313-7071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEVAN",
        "first_name": "EMILY",
        "middle_name": "REUS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD6064414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2065249",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ereus1043049@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "751 NE Blakely Dr Ste 230",
            "city": "Issaquah",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980296201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "REUS",
            "middle_name": "S",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Truckee, CA

Sources for this page

Verify at the official NPI Registry.