Jacob Jun Tsukamoto

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

7481707 Issued in ID

Practice address

934 S Main St
Layton, UT 84041-7135

Phone

(801) 336-1845

NPI assigned

Oct 19, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1083180798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417135",
            "telephone_number": "801-336-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417135",
            "telephone_number": "801-336-1845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSUKAMOTO",
        "first_name": "JACOB",
        "middle_name": "JUN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-19",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ID",
            "license": "7481707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Trujillo
• Jacqueline Trujillo, RN
• Megan Reyes Trujillo
• Bradley Bryce Trump, LCSW
• Sandra Trump
• Micah Tu
• Annselina Tu'Aefe
• Gerilyn Tubbs
• Ruby Yvette Tuchyner
• Alexsa Tucker

• Student in an Organized Health Care Education/Training Program in Layton, UT
• Providers in Layton, UT by specialty
• Student in an Organized Health Care Education/Training Program in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.