MOUNTAIN WEST DERM - BLACKHART PLLC SOS Verified
640 W MOANA LN, RENO, NV 89509
NPI Number
1740633015
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: MOUNTAIN WEST DERM - BLACKHART, PLLC
Entity Number: E0312902016-7
Entity Type: Domestic Professional LLC
Entity Status: Active
Formation Date: 2016-07-14
Status Changed: 2017-08-29
Name Match: 95%
Registered Agent
Name: CORPORATION SERVICE COMPANY*
Type: Commercial Registered Agent
Address: 112 NORTH CURRY STREET, Carson City, NV, 89703
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Manager | BRET BLACKHART M.D. | 640 WEST MOANA LANE, RENO, NV, 89509 | Active |
| Manager | JEFFREY SHACKELTON M.D. | 640 WEST MOANA LANE, RENO, NV, 89509 | Active |
Total Medicaid Payments
$767
-100% vs specialty average
Patients Seen
1,006
Total Claims
1,062
$ Per Patient
$1
Specialty avg: $50
Specialty Rank
#5 of 5
Dermatology, MOHS-Micrographic Surgery providers in Nevada
Peer Average
$160,487
Average total for Dermatology, MOHS-Micrographic Surgery
Claims per Patient
1.1
Average visits / services per person
Payments by Year
How much Medicaid paid this provider each year. Large jumps can indicate changes in practice volume or billing patterns.
| Year | Total Paid | % of Max |
|---|---|---|
| 2018 | $0 | |
| 2019 | $186 | |
| 2020 | $282 | |
| 2021 | $239 | |
| 2022 | $54 | |
| 2023 | $6 |
Procedure Code Breakdown
The specific medical services this provider billed Medicaid for. Each HCPCS/CPT code represents a different type of visit, test, or treatment.
| HCPCS Code | Description | Claims | Paid | % of Total | Avg per Claim |
|---|---|---|---|---|---|
| 88305 | Tissue examination under a microscope (surgical pathology) | 761 | $694 | 90.5% | $1 |
| 99213 | Office visit for a simple problem (established patient) | 163 | $72 | 9.5% | $0 |
| 17003 | Destruction of additional precancerous skin growths | 14 | $0 | 0.0% | $0 |
| 99214 | Office visit for a moderate problem (established patient) | 16 | $0 | 0.0% | $0 |
| 11102 | Skin biopsy — taking a small sample of skin to test for disease | 27 | $0 | 0.0% | $0 |
| 11100 | Skin biopsy — taking a small sample to test for disease | 40 | $0 | 0.0% | $0 |
| 17000 | Destruction of a precancerous skin growth (first growth) | 41 | $0 | 0.0% | $0 |
About This Data
This data comes from the HHS Medicaid Provider Spending dataset (opendata.hhs.gov). It shows payments made through Nevada Medicaid from 2018–2024. High payments do not mean a provider is doing anything wrong — some specialties naturally cost more, and busy providers see more patients. But unusually high numbers compared to peers can be worth a closer look.