Ryan Tognotti , PA-C
Physician Assistant • Carson City, NV
973 Mica Dr. Suite 201
Carson City, NV 89705
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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NPI assigned on July 10, 2020; this date does not establish years in practice.
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Published CMS data list 1,142 Original Medicare Part B services in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Published rows only; this is not a quality measure.
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Published Part B service records, 2024:
- J3301 — Injection, triamcinolone acetonide, not otherwise specified, 10 mg: 560 service units.
- 99214 — Established patient outpatient office visit: 181 service units.
- 20610 — Aspiration and/or injection of fluid from large joint: 132 service units.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Units differ by code; these are not visits or a measure of quality.
CPT® only copyright 2023 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2024). CPT notice
See all 10 records in the table · Guide: How to read Medicare Part B data
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Published CMS data list 160 Medicare Part D prescriptions, including refills, in 2024.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Published rows only; this is not a quality measure.
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Published Part D records, 2024:
- Oxycodone-Acetaminophen (Oxycodone Hcl/Acetaminophen) — 44 prescription fills, including refills.
- Diclofenac Sodium — 34 prescription fills, including refills.
- Tramadol Hcl — 27 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See all 6 records in the table · Guide: How to read Medicare Part D prescriber data
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Close to the middle for Medicare Part B services among clinicians listed under Physician Assistant in Carson City, NV (2024, 15 clinicians with data). Median for this group: 1,142. Middle half: 558 to 1,647.
More Medicare Part B services than 75% of clinicians listed under Physician Assistant in Nevada (2024, 551 clinicians with data). Median for this group: 239. Middle half: 99 to 900.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Billing and prescribing volume is not a quality rating.
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Medicare Part B services went from 517 in 2022 to 1,142 in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2022–2024.
Practice Location & Contact Primary Location
973 Mica Dr. Suite 201
Carson City, NV 89705
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
CMS Doctors and Clinicians lists 1 group name: James J Lynch Md Ltd. See the list
Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.
Listings do not confirm current availability, employment or a shared ownership network.
Medicare Profile & Education
Source: CMS Doctors and Clinicians National Downloadable File
2021
What Public CMS Data Show
Physician Assistant: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare patients
237 people with Original Medicare in 2024
It gives a sense of how many people with Medicare this clinician treated that year.
Source: CMS, Medicare Physician & Other Practitioners – by Provider, 2024.
Medicare-allowed amount
About $46,346 in 2024
The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.
Paid by Medicare
About $33,040 in 2024
The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.
30-day fills
163 standardized 30-day fills in 2024
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$1,193 in 2024
The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024.
Open Payments general payments, program year 2025
All general payments: $460.75 across 12 records.
By nature of payment
- Food and Beverage: $460.75 across 12 records.
Reporting-company totals (3 largest of 7)
- Miach Orthopaedics, Inc.: $196.57 across 1 record.
- Goode Surgical Inc: $67.32 across 3 records.
- VERTEX PHARMACEUTICALS INCORPORATED: $56.91 across 2 records.
A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.
Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).
Years since graduation
5 years (graduated 2021)
CMS Doctors and Clinicians data list 2021 as the year this clinician finished professional school.
It tells you roughly how long ago the clinician finished school.
What this does not show: Years since graduation
It is not the number of years in practice, and more years does not mean better care.
Source: CMS Doctors and Clinicians National Downloadable File.
NPI first issued
2020
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Accepts Medicare assignment
CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.
With Original Medicare, you usually pay only your deductible and coinsurance, and the office sends the claim to Medicare for you.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Enrolled in Medicare (PECOS)
Ryan Tognotti has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Ryan Tognotti as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Carson City and Nevada
Billing and prescribing volume is not a quality rating.
Medicare Part B services
Close to the middle for clinicians listed under Physician Assistant in Carson City, NV (2024, 15 clinicians with data). Median for this group: 1,142. Middle half: 558 to 1,647.
More Medicare Part B services than 75% of clinicians listed under Physician Assistant in Nevada (2024, 551 clinicians with data). Median for this group: 239. Middle half: 99 to 900.
Medicare-allowed amount
A lower Medicare-allowed amount than 70% of clinicians listed under Physician Assistant in Carson City, NV (2024, 15 clinicians with data). Median for this group: $72,073. Middle half: $44,793 to $122,302.
A higher Medicare-allowed amount than 70% of clinicians listed under Physician Assistant in Nevada (2024, 551 clinicians with data). Median for this group: $19,039. Middle half: $8,218 to $51,606.
Paid by Medicare
A lower Medicare payment amount than 70% of clinicians listed under Physician Assistant in Carson City, NV (2024, 15 clinicians with data). Median for this group: $54,171. Middle half: $32,662 to $92,866.
A higher Medicare payment amount than 70% of clinicians listed under Physician Assistant in Nevada (2024, 551 clinicians with data). Median for this group: $14,357. Middle half: $5,921 to $37,821.
Medicare Part D prescriptions
Fewer Part D prescriptions than 80% of clinicians listed under Physician Assistant in Carson City, NV (2024, 20 clinicians with data). Median for this group: 551. Middle half: 184 to 1,384.
Fewer Part D prescriptions than 60% of clinicians listed under Physician Assistant in Nevada (2024, 617 clinicians with data). Median for this group: 324. Middle half: 94 to 1,300.
Part D drug cost
A lower Part D drug cost than 75% of clinicians listed under Physician Assistant in Carson City, NV (2024, 20 clinicians with data). Median for this group: $9,768. Middle half: $2,137 to $81,584.
A lower Part D drug cost than 65% of clinicians listed under Physician Assistant in Nevada (2024, 617 clinicians with data). Median for this group: $7,774. Middle half: $876 to $106,842.
29 active clinicians are listed under Physician Assistant with a practice address in Carson City, NV (1,084 in Nevada).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Carson City
3.4% of these 29 clinicians have the CMS telehealth indicator.
58.6% of these 29 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services increased 121% from 517 in 2022 to 1,142 in 2024.
- 2022: 517
- 2023: 867
- 2024: 1,142
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Medicare-allowed amount
Medicare-allowed amount increased 109% from $22,215 in 2022 to $46,346 in 2024.
- 2022: $22,215
- 2023: $38,554
- 2024: $46,346
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Paid by Medicare
Paid by Medicare increased 93% from $17,160 in 2022 to $33,040 in 2024.
- 2022: $17,160
- 2023: $28,873
- 2024: $33,040
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Medicare Part D prescriptions
Medicare Part D prescriptions increased 186% from 56 in 2022 to 160 in 2024.
- 2022: 56
- 2023: 69
- 2024: 160
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30-day fills
30-day fills increased 191% from 56 in 2022 to 163 in 2024.
- 2022: 56
- 2023: 69
- 2024: 163
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Part D drug cost
Part D drug cost went from $375 in 2022 to $1,193 in 2024.
- 2022: $375
- 2023: $399
- 2024: $1,193
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Industry payments (Open Payments)
Industry payments (Open Payments) decreased 85% from $3,135.79 in 2022 to $460.75 in 2025.
- 2022: $3,135.79
- 2023: $844.84
- 2024: $231.64
- 2025: $460.75
Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Pharma & Medical Device Financial Disclosures
Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments
Program year 2025 (payments made January 1 – December 31, 2025): 12 records totaling $460.75.
| Manufacturer | Payment Nature | Product | Type | Amount ($) |
|---|---|---|---|---|
| Miach Orthopaedics, Inc. |
Food and Beverage
Cash or cash equivalent
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— | General | $196.57 |
| Bioventus LLC |
Food and Beverage
In-kind items and services
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EXOGEN ULTRASOUND BONE HEALING SYSTEM | General | $32.22 |
| VERTEX PHARMACEUTICALS INCORPORATED |
Food and Beverage
In-kind items and services
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JOURNAVX | General | $28.78 |
| Goode Surgical Inc |
Food and Beverage
In-kind items and services
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— | General | $28.70 |
| VERTEX PHARMACEUTICALS INCORPORATED |
Food and Beverage
In-kind items and services
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JOURNAVX | General | $28.13 |
| Amgen Inc. |
Food and Beverage
In-kind items and services
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KRYSTEXXA | General | $27.00 |
| DePuy Synthes Sales Inc. |
Food and Beverage
In-kind items and services
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MONOVISC | General | $22.73 |
| MOXIMED, INC |
Food and Beverage
In-kind items and services
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MISHA KNEE SYSTEM, SMALL, LEFT | General | $21.62 |
| Goode Surgical Inc |
Food and Beverage
In-kind items and services
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— | General | $20.70 |
| DePuy Synthes Sales Inc. |
Food and Beverage
In-kind items and services
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MONOVISC | General | $20.32 |
| Goode Surgical Inc |
Food and Beverage
In-kind items and services
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— | General | $17.92 |
| Bioventus LLC |
Food and Beverage
In-kind items and services
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EXOGEN ULTRASOUND BONE HEALING SYSTEM | General | $16.06 |
Source: CMS Open Payments, program year 2025, released June 30, 2026.
Performed Procedures & Service Volume
CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2021–2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners – by Provider and Service data, 2022–2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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J3301
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
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560 | 88 | $10.00 | $0.97 |
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99214
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
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181 | 135 | $558.00 | $104.62 |
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20610
Aspiration and/or injection of fluid from large joint
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132 | 96 | $1090.32 | $60.91 |
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73564
X-ray of knee, 4 or more views
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67 | 53 | $450.00 | $38.87 |
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99213
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
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62 | 44 | $264.00 | $75.50 |
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99204
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
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56 | 56 | $671.00 | $138.71 |
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73030
X-ray of shoulder, minimum of 2 views
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39 | 28 | $400.00 | $29.12 |
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73562
X-ray of knee, 3 views
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18 | 14 | $300.00 | $34.02 |
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80307
Testing for presence of drug, by chemistry analyzers
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15 | 15 | $876.00 | $60.90 |
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99203
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
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12 | 12 | $450.00 | $92.69 |
Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2024.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Oxycodone-Acetaminophen | Oxycodone Hcl/Acetaminophen | 44 | 206 | $423.49 | 36 |
| Diclofenac Sodium | Diclofenac Sodium | 34 | 990 | $301.37 | 20 |
| Tramadol Hcl | Tramadol Hcl | 27 | 129 | $50.54 | 22 |
| Celecoxib | Celecoxib | 22 | 660 | $268.79 | — |
| Meloxicam | Meloxicam | 17 | 600 | $40.67 | — |
| Methylprednisolone | Methylprednisolone | 16 | 96 | $107.66 | 16 |
Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2021-12-15NUCC Taxonomy Code: 363A00000X
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - PHYSICIAN ASSISTANT
I20211217002211
NV
8820489206
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Medicare Group Practice Enrollments
Source: CMS Doctors and Clinicians National Downloadable File
James J Lynch Md Ltd
780 Vista Blvd, Sparks, NV 894346677
Phone: 7753488800
James J Lynch Md Ltd
973 Mica Dr, Carson City, NV 897057258
Phone: 7757836190
James J Lynch Md Ltd
10539 Professional Cir, Reno, NV 895213858
Phone: 7757936190
James J Lynch Md Ltd
2874 N Carson St, Carson City, NV 897061681
Phone: 7757836190
James J Lynch Md Ltd
1470 Medical Pkwy, Carson City, NV 897034647
Phone: 7753488800
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Nurse Practitioner
Advanced Practice Registered Nurse
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Registered at 973 MICA DR. SUITE 201, CARSON CITY, NV 89705 (Tel: 7757836109)
Registered at 973 MICA DR STE 201, CARSON CITY, NV 897057258 (Tel: 7757836109)
Recorded as RYAN TOGNOTTI, PAC
Physician Assistant (license number reported to NPPES: NV PA2517)
NPI status registered as active in NPPES database
Registered at 18600 WEDGE PKWY, RENO, NV 895113036 (Tel: 7757844843)
Registered at 18600 WEDGE PKWY, RENO, NV 895113036
Recorded as RYAN TOGNOTTI
Student in an Organized Health Care Education/Training Program
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Other Physician Assistants in Carson City
- Arthur Roberts, PA-C
- Stephanie Elmquist, PA-C
- Margaret Patterson
- Arthur Paniagua, PA-C
- Tatiana Warner, PA
- Jeromy Dyer
More public profiles in Nevada
Directory navigation, in NPI number order.
- Sarah Russell, LCSW Social Worker - Clinical · Carson City
- Aashish Khullar Internal Medicine · Reno
- Marie Duan Meservy Radiology - Diagnostic Radiology · Reno
- Karen Hill-Fisher, MS, RD, CDE Dietitian, Registered · Reno
- Lisa Halpin, MS, CCC-SLP Speech-Language Pathologist · Henderson
- Amani Altamimi, MD Hospitalist · Reno
- Annamieka Conway, MD Ophthalmology · Carson City
- Dannette Lammert, OD Optometrist · Las Vegas
- Daniel Navarro, DNP, APRN, FNP-C Nurse Practitioner - Family · Las Vegas
- Garrett Green, MD Radiology - Radiation Oncology · Reno
- Kevin Golshani, MD Orthopaedic Surgery - Hand Surgery · Henderson
- Amy Sullivan, OD Optometrist · Winnemucca
Mailing Address
973 Mica Dr Ste 201
Carson City, NV 897057258
Phone: 7757836109