Nevada Advanced Pain Specialists – Physical Medicine & Rehabilitation Physician, NPI 1619101045
Physical Medicine & Rehabilitation Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Nevada Advanced Pain Specialists
2385 E Prater Way Ste 204
Sparks, NV 894349688
Phone: (775) 284-8650
Type: Location
5578, Longley Lane, Reno, Washoe County, Nevada, 89511, United States
RENO, NV 895111825
Phone: (775) 284-8650
Fax: (775) 284-8654
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-05-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20090731000179 | O | Clinic/Group Practice | NV | TBD |
| O20110115000051 | O | Physician - Osteopathic Manipulative Medicine | NV | TBD |
| O20230426002090 | O | Clinic/Group Practice | AZ | TBD |
| O20250528001029 | O | Clinic/Group Practice | TX | TBD |
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.
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 89434)
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