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MOUNTAIN WEST DERM - BLACKHART PLLC
NPI 1740633015
Dermatology - MOHS-Micrographic Surgery in Reno, NV

Active since July 21, 2016
640 W MOANA LN, RENO, NV 89509(775) 324-0699(775) 323-6814 Get Directions Write a Review

NPPES record last updated: July 30, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mountain West Derm - Blackhart Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOUNTAIN WEST DERM - BLACKHART PLLC (NPI 1740633015) is a healthcare organization registered as a mohs-micrographic surgery in Reno, Nevada and active in the NPI registry since July 2016. The organization maintains 10 additional practice locations and lists Bret Blackhart, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1740633015
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameMOUNTAIN WEST DERM - BLACKHART PLLC
Location Address640 W MOANA LNReno, NV 89509-4903
Mailing Address3950 Gs Richards BlvdCarson City, NV 89703-8457 · (775) 882-8777 · Fax (775) 888-8062
Phone(775) 324-0699
Fax(775) 323-6814
Organization SubpartNo
Authorized OfficialBret BlackhartManaging Partner · (775) 882-8777
Enumeration DateJuly 21, 2016
Last NPPES UpdateJuly 30, 2025
NPPES CertifiedJuly 30, 2025
✔ NPI 1740633015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
License✔ Licensed in NV · 193400000X
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
640 W MOANA LN, Reno, NV 89509
Open in Google Maps ↗

Secondary Practice Locations 10

Location 19672 S McCarran BlvdReno, NV 89523-9205 · Phone (775) 324-0699 · Fax (775) 323-6814
Location 23640 Warren Way Ste 200Reno, NV 89509-5240 · Phone (775) 324-0699 · Fax (775) 826-4820
Location 33640 Warren Way Ste 100Reno, NV 89509-5240 · Phone (775) 324-0699 · Fax (775) 336-3666
Location 43950 Gs Richards BlvdCarson City, NV 89703-8457 · Phone (775) 882-8777 · Fax (775) 888-8062
Location 55419 Reno Corporate DrReno, NV 89511-2250 · Phone (775) 324-0699 · Fax (775) 323-6814
Location 64814 Sparks BlvdSparks, NV 89436-8219 · Phone (775) 324-0699 · Fax (775) 451-7501
Location 7917 Tahoe Blvd Ste 101Incline Village, NV 89451-7484 · Phone (775) 324-0699 · Fax (775) 298-7324
Location 810479 Double R BlvdReno, NV 89521-8905 · Phone (775) 850-8600 · Fax (775) 850-8665
Location 91825 Pinion Rd Ste FElko, NV 89801-8319 · Phone (775) 299-4778 · Fax (775) 299-4690
Location 10607 S Maine StFallon, NV 89406-3801 · Phone (775) 428-1007 · Fax (775) 888-8062

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mountain West Derm - Blackhart Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

31

Medicare enrollment records show 31 clinicians reassign Medicare billing to Mountain West Derm - Blackhart PLLC, which bills Medicare for the services they deliver. Of these, 14 practice at this address and 26 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 4

Dermatology18
Nurse Practitioner10
Micrographic Dermatologic Surgery (MDS)2
Internal Medicine1

Nearest to this location (20)

See all 31
Anthony Albregts, M.D.
Dermatology
NPI 1093718751
640 W MOANA LN
Reno, NV 89509
(775) 336-3624
✔ PECOS✔ Accepts MedicareSame address
Bret Blackhart, M.D.
Dermatology
NPI 1992708655
640 W MOANA LN STE 2
Reno, NV 89509
(775) 324-0699
✔ PECOSSame address
Elizabeth Cassinelli, M.D.
Dermatology
NPI 1710372743
640 W MOANA LN
Reno, NV 89509
(775) 324-0699
✔ PECOS✔ Accepts MedicareSame address
Shaundra Eichstadt, MD
Micrographic Dermatologic Surgery (MDS)
NPI 1174849194
640 W MOANA LN
Reno, NV 89509
(775) 324-0699
✔ PECOS✔ Accepts MedicareSame address
Bruce Fuller, M.D.
Dermatology
NPI 1588861397
640 W MOANA LN
Reno, NV 89509
(775) 324-0699
✔ PECOS✔ Accepts MedicareSame address
Brad Hammon, D.O.
Dermatology
NPI 1114388204
640 W MOANA LN
Reno, NV 89509
(775) 350-7831
✔ PECOS✔ Accepts MedicareSame address
Kevin Kiene, M.D.
Dermatology
NPI 1881697548
640 W MOANA LN
Reno, NV 89509
(775) 324-0699
✔ PECOS✔ Accepts MedicareSame address
Kimberly Kolar, M.D.
Dermatology
NPI 1144223801
640 W MOANA LN STE 2
Reno, NV 89509
(775) 324-0699
✔ PECOS✔ Accepts MedicareSame address
Brian Reece, MSN, APRN, FNP-C
Nurse Practitioner
NPI 1568089084
640 W MOANA LN
Reno, NV 89509
(775) 324-0699
✔ PECOS✔ Accepts MedicareSame address
Jeffrey Shackelton, M.D.
Dermatology
NPI 1699902726
640 W. MOANA LANE
Reno, NV 89509
(775) 324-0699
✔ PECOS✔ Accepts MedicareSame address
Michael Zumwalt, M.D.
Dermatology
NPI 1275947764
640 W MOANA LN
Reno, NV 89509
(775) 324-0699
✔ PECOS✔ Accepts MedicareSame address
Whitney Hovenic, M.D.
Dermatology
NPI 1487826764
640 W MOANA LN
Reno, NV 89509
(775) 324-0699
✔ PECOS✔ Accepts MedicareSame address
Franz Stadler, M.D.
Dermatology
NPI 1578566873
640 W MOANA LN
Reno, NV 89509
(775) 324-0699
✔ PECOS✔ Accepts MedicareSame address
Rhonda Strunk, APN-C
Nurse Practitioner
NPI 1659374940
640 W MOANA LN STE 2
Reno, NV 89509
(775) 324-0699
✔ PECOSSame address
Anna Ellis, APRN
Nurse Practitioner
NPI 1285032482
6536 S MCCARRAN BLVD STE B
Reno, NV 89509
(775) 982-8255
✔ PECOS✔ Accepts Medicare1.1 mi
Katherine Manno, MD
Dermatology
NPI 1225474224
6536 S MCCARRAN BLVD STE B
Reno, NV 89509
(775) 982-5595
✔ PECOS✔ Accepts Medicare1.1 mi
Lisa Zaleski, D.O.
Dermatology
NPI 1336296912
650 SIERRA ROSE DR STE A
Reno, NV 89511
(775) 827-8100
✔ PECOS✔ Accepts Medicare1.3 mi
Jerika Bernard, APRN
Nurse Practitioner
NPI 1992336499
975 RYLAND ST STE 100
Reno, NV 89502
(775) 982-5000
✔ PECOS✔ Accepts Medicare2.3 mi
Tera Zuccarini, APRN
Nurse Practitioner
NPI 1184147993
975 RYLAND ST STE 100
Reno, NV 89502
(775) 982-5000
✔ PECOS✔ Accepts Medicare2.3 mi
Laura Hay, APN
Nurse Practitioner
NPI 1891935268
555 N. ARLINGTON AVENUE
Reno, NV 89503
(775) 786-3040
✔ PECOS✔ Accepts Medicare2.9 mi
See all 31 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mountain West Derm - Blackhart PLLC's NPI number?

The NPI number for Mountain West Derm - Blackhart PLLC is 1740633015. It was assigned to this organization in the NPPES registry on July 21, 2016.

Where is Mountain West Derm - Blackhart PLLC located?

Mountain West Derm - Blackhart PLLC is located at 640 W Moana Ln, Reno, NV 89509. The listed phone number is (775) 324-0699.

What is Mountain West Derm - Blackhart PLLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Mountain West Derm - Blackhart PLLC enrolled in Medicare?

Yes. Mountain West Derm - Blackhart PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mountain West Derm - Blackhart PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 31 clinicians in 4 Medicare specialties reassign their Medicare billing to Mountain West Derm - Blackhart PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (18), Nurse Practitioner (10) and Micrographic Dermatologic Surgery (MDS) (2). Of these, 14 practice at this address and 26 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Mountain West Derm - Blackhart PLLC accept?

Health plans from Ambetter from Arizona Complete Health, BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Mountain West Derm - Blackhart PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mountain West Derm - Blackhart PLLC was last updated on July 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.