Individual provider Active NPI

Jason Waite, DPM

  • Podiatrist
  • Las Vegas, NV
National Provider Identifier
1073950440
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
9114085-0501 Issued in UT
Practice address
1257 Paiute Cir
Las Vegas, NV 89106-3202
Phone
(516) 506-8839
NPI assigned
May 25, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 9114085-0501 UT
Podiatrist 213E00000X 9114085-0501 UT Primary

Addresses

Primary practice location

1257 Paiute Cir
Las Vegas, NV 89106-3202

Mailing address

PO Box 110
Castle Dale, UT 84513-0110
Phone (516) 506-8839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180618001476 TX Practitioner - Podiatry 9739313537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Irene Benn Medical CenterGroup PAC ID 0840430724, 4 clinicians

Practice addresses (Care Compare)

10 Lincoln St
Moapa, NV 89025-0819
Phone (702) 865-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9114085-0501UTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Irene Benn Medical Center CurrentSince May 9, 2018 Accepting new patients

Locations

12033 Agency Rd
Parker, AZ 85344
Phone (760) 572-4137

Interoperability endpoints

  • Direct secure messaging: jason.waite@lvpt.directbygreenway.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1073950440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110",
            "city": "CASTLE DALE",
            "state": "UT",
            "postal_code": "845130110",
            "telephone_number": "516-506-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1257 PAIUTE CIR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063202",
            "telephone_number": "516-506-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITE",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-25",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "UT",
            "license": "9114085-0501",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "9114085-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.