NICHOLAS ANDRE BEAUDETTE – Medical Physician Assistant, NPI 1578254686

NICHOLAS ANDRE BEAUDETTE is a healthcare provider. based in Reno, Nevada. specializing in PHYSICIAN ASSISTANT. They hold a License No. PA3110 (NV). The NPI Number for NICHOLAS ANDRE BEAUDETTE is 1578254686

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLAS ANDRE BEAUDETTE
NPI
1578254686
Phone
(775) 220-5540
Address
4330 ACADIA WAY
Enumeration Date
18 May 2023
Last Update Date
7 May 2025

Doctor Profile

Medical School Name
UNIVERSITY OF NEVADA SCHOOL OF MEDICINE
Secondary Phone
7756895410
Graduation Year
2024 (2 years ago)
PAC ID
9032643341
Group Practice PAC ID
9638177058
Professional Enrollment ID
I20241108002721
Address ID
NV895112093RE605XXDRXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

1,223 PHYSICIAN ASSISTANT in NV

Provider Addresses for NICHOLAS ANDRE BEAUDETTE

  • 4330 ACADIA WAY

    RENO, NV 895026304

    Phone: (775) 220-5540

    Fax: (775) 220-5540

    Type: Mailing

  • 605 SIERRA ROSE DR STE 4

    RENO, NV 895112093

    Phone: (775) 689-5410

    Fax: (775) 786-4031

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 8 Open Payments records for all available years, with a total value of $487.

Total Amount is formed as General ($487) + Research ($0) + Ownership ($0) = $487.

Last reported payment date: 2024-12-07 • Largest payer in this snapshot: Medtronic, Inc. ($487).

Total Amount

$487

General + Research + Ownership

Payments

8

Total payment records

General Amount

$487

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-07

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Medtronic, Inc.$487
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: 2024-11-08

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
I20241108002721IPhysician 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 89502)

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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: 9638177058View full group profile
NameSpecialtyState
Nurse PractitionerNV
Pain ManagementNV
Nurse PractitionerNV
Physician AssistantNV
-NV
Physician AssistantNV
Nurse PractitionerNV
Interventional Pain Management, AnesthesiologyNV
Physical Therapist In Private PracticeNV
Anesthesiology, Pain ManagementNV

Reviews

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Frequently asked questions

What is NICHOLAS ANDRE BEAUDETTE's NPI number?
NICHOLAS ANDRE BEAUDETTE's NPI is 1578254686 — the number used across U.S. healthcare to identify this provider.
Is NICHOLAS ANDRE BEAUDETTE still an active registrant?
NICHOLAS ANDRE BEAUDETTE carries an active NPI according to the public dataset.
How would a patient describe NICHOLAS ANDRE BEAUDETTE's focus?
For NICHOLAS ANDRE BEAUDETTE, the primary taxonomy reads as Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is NICHOLAS ANDRE BEAUDETTE located near Reno?
NICHOLAS ANDRE BEAUDETTE currently maps to Reno, Nevada in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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