Unknown Individual – Physician Assistant, NPI 1962407684

Unknown Individual is a healthcare provider. based in Reno, Nevada. specializing in Physician Assistant. They hold a License No. PA1015616 (NV). The NPI Number for Unknown Individual is 1962407684

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1962407684
Phone
(775) 323-2135
Address
640 W MOANA LN
Deactivation Date
4 February 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7753240699
Graduation Year
1985 (41 years ago)
PAC ID
5496838500
Group Practice PAC ID
1153609813
Professional Enrollment ID
I20080213000294
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

  • 640, West Moana Lane, Reno, Washoe County, Nevada, 89509, United States

    STE 2

    RENO, NV 895094857

    Phone: (775) 323-2135

    Fax: (775) 323-6435

    Type: Mailing

  • 704, West Nye Lane, Carson City, Nevada, 89703, United States

    STE 203

    CARSON CITY, NV 897031572

    Phone: (775) 882-8777

    Fax: (775) 888-8062

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

No Medicare enrollment or revalidation data available for this provider in our database.

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 89509)

Loading plans...

Provider's Procedures

Unknown Individual performs procedures in Physician Assistant. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTNV11101Biopsy of each additional growth of skin and/or tissue263169
PHYSICIAN ASSISTANTNV17003Destruction of 2-14 skin growths4288585

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: 1153609813View full group profile
NameSpecialtyState
IRENE HELEN MANNERING (M.D.)
D E R M A T O L O G YNV
ASHLEY OWENS (PA-C)
Physician AssistantNV
MICHAEL J HOUSLEY (PA-C)
Physician AssistantID
ANTHONY E ALBREGTS (M.D.)
D E R M A T O L O G YNV
STEPHANIE ANN MCLEISH (M.D.)
-AK
DR. JAMES H STEWART (PHD, MD)
-ID
BRAD WILLIAM HAMMON (D.O.)
D E R M A T O L O G YOH
MONICA SCHEPP (PA)
Physician AssistantTX
KIMBERLY A KOLAR (M.D.)
D E R M A T O L O G YNV
SEAN M. HEALY (PA-C)
Physician AssistantOR

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1962407684.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Physician Assistant for Unknown Individual. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Reno, Nevada. Check all listed addresses for suites or satellite offices.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

Similar Providers

DENNIS KIESEL (P.A.-C)

Surgical Physician Assistant
East 1st Street, Duluth, Saint Louis County, Minnesota, 55804, United States
NPI: 1154326676

MR. ROBERT AARON FRANKEL (PA-C)

850, Harvard Way, Reno, Washoe County, Nevada, 89502, United States
NPI: 1225020118

Reno Orthopedic Center

Orthopaedic Surgery Physician
Reno Orthopedic Clinic, 555, North Arlington Avenue, Reno, Washoe County, Nevada, 89503, United States
NPI: 1245228972

BRUCE DARIN GALLIO (PA-C)

Physician Assistant
Reno Orthopedic Clinic, 555, North Arlington Avenue, Reno, Washoe County, Nevada, 89503, United States
NPI: 1134117914

AMY RACHELLE SCHOENING (PA-C)

Physician Assistant
West Moana Lane, Reno, Washoe County, Nevada, 89502, United States
NPI: 1154305159

CURTIS JAMES SMITH (PA-C)

Surgical Physician Assistant
Saint Mary's Center for Health, 645, North Arlington Avenue, Reno, Washoe County, Nevada, 89503, United States
NPI: 1366428187

PAUL JOHNS (PA-C)

Physician Assistant
880, Ryland Street, Reno, Washoe County, Nevada, 89502, United States
NPI: 1740266568

Silver Springs Rural Health Centers

Rural Health Clinic/Center
850, Harvard Way, Reno, Washoe County, Nevada, 89502, United States
NPI: 1316925381

Faster Care

Family Medicine Physician
780, Kuenzli Street, Reno, Washoe County, Nevada, 89502, United States
NPI: 1215915285