CHARLES W BREAUX, MD — NPI 1407844301 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery

CMS-1500 Box 24J / 33a • NPI

1407844301

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

2086S0120X (CMS 02)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Pediatric Surgery

Box 32 Service Location & ZIP+4

1155 MILL ST, RENO, NV, 89502-1576

✓ 9-Digit EDI 837 ZIP+4 (89502-1576)

Practice Phone & Referral Fax

(775) 982-2125

Fax: (775) 982-2170

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1407844301 (CHARLES W BREAUX, MD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1407844301` (NPI-1 Individual Practitioner)
Provider / Legal Name	CHARLES W BREAUX, MD
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Pediatric Surgery NUCC Code: `2086S0120X` (Surgery, Pediatric Surgery)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1155 MILL ST, RENO, NV, 89502-1576
Practice Telephone / Fax	Tel: (775) 982-2125 \| Fax: (775) 982-2170
Administrative Mailing Address	PO BOX 507, FRUITA, CO, 81521-0507
Enumeration & Last Sync	Enumerated: 2005-10-13 \| CMS Record Updated: 2025-01-16

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1155 MILL ST, RENO, NV, 89502-1576

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Plain-English Taxonomy & CMS Crosswalk (2086S0120X)

What Does Taxonomy Code 2086S0120X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2086S0120X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Pediatric Surgery"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Surgery, Pediatric Surgery for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (CHARLES W BREAUX, MD)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`208600000X` — Surgery Plain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)	State: AL \| License: `11154` \| Primary: Secondary
`208600000X` — Surgery Plain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)	State: CO \| License: `35211` \| Primary: Secondary
`208600000X` — Surgery Plain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)	State: NV \| License: `26701` \| Primary: Secondary
`2086S0102X` — Surgery, Surgical Critical Care Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Surgical Critical Care	State: AL \| License: `11154` \| Primary: Secondary
`2086S0102X` — Surgery, Surgical Critical Care Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Surgical Critical Care	State: CO \| License: `35211` \| Primary: Secondary
`2086S0120X` — Surgery, Pediatric Surgery Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Pediatric Surgery	State: AL \| License: `11154` \| Primary: Secondary
`2086S0120X` — Surgery, Pediatric Surgery Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Pediatric Surgery	State: CO \| License: `35211` \| Primary: Secondary
`2086S0120X` — Surgery, Pediatric Surgery Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Pediatric Surgery	State: NV \| License: `26701` \| Primary: Yes (Primary)

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CHARLES W BREAUX, MD (NPI #1407844301)