RODEZZA SACAYAN TABANO (PA) – Physician Assistant, NPI 1013696301

RODEZZA SACAYAN TABANO (PA) is a healthcare provider. based in Henderson, Nevada. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA2992 (NV). The NPI Number for RODEZZA SACAYAN TABANO (PA) is 1013696301

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
RODEZZA SACAYAN TABANO (PA)
NPI
1013696301
Phone
Not provided
Address
3175 SAINT ROSE PKWY STE 121
Enumeration Date
13 July 2023
Last Update Date
6 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2023 (3 years ago)
PAC ID
1658801873
Group Practice PAC ID
1658425210
Professional Enrollment ID
I20250203003454
Address ID
NV891102198LA3551XRDXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

1,223 PHYSICIAN ASSISTANT in NV

Provider Addresses for RODEZZA SACAYAN TABANO (PA)

  • 3175 SAINT ROSE PKWY STE 121

    HENDERSON, NV 890523507

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $305.

Total Amount is formed as General ($305) + Research ($0) + Ownership ($0) = $305.

Last reported payment date: 2024-10-07 • Largest payer in this snapshot: Abbott Laboratories ($146).

Total Amount

$305

General + Research + Ownership

Payments

4

Total payment records

General Amount

$305

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-07

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-02-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250203003454IPhysician AssistantNVTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 89052)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658425210View full group profile
NameSpecialtyState
Family PracticeNV
Physician AssistantNV
Family PracticeNV
Physician AssistantNV
Physician AssistantNV
Physician AssistantNV

Reviews

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Frequently asked questions

What number should I use to identify RODEZZA SACAYAN TABANO (PA) for billing?
Administrative and clinical systems typically use NPI 1013696301 for RODEZZA SACAYAN TABANO (PA).
Is RODEZZA SACAYAN TABANO (PA) currently accepting referrals based on NPI status?
Registry metadata lists RODEZZA SACAYAN TABANO (PA) as active.
What type of care does RODEZZA SACAYAN TABANO (PA) provide?
RODEZZA SACAYAN TABANO (PA)'s profile centers on Physician Assistant. Clinical services aligned with this taxonomy classification.
Is RODEZZA SACAYAN TABANO (PA) tied to Henderson, Nevada?
If you are local to Henderson, Nevada, RODEZZA SACAYAN TABANO (PA) may be relevant to your search.
Why is information missing for RODEZZA SACAYAN TABANO (PA)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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