Jacob H Nelson, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

0832 Issued in AZ

Practice address

5432 E Southern Ave Ste 101B
Mesa, AZ 85206-2772

Phone

(480) 210-3336

Fax

(480) 210-3339

NPI assigned

Jul 11, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Podiatry

Education

Arizona Podiatric Med Program at Midwestern Un, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sole Foot and Ankle Specialists PCGroup PAC ID 8729986955, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/11c92883-3ba8-4054-8136-467108df0876/
• FHIR API: https://fhir4.healow.com/fhir/r4/HICCDA/Endpoint/HICCDA

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.

• Mountain View Foot & Ankle LLC

  • Foot & Ankle Surgery Podiatrist
  • Mesa, AZ
  • NPI 1386389849
  Medicare reassignment NPD Authorized official
• Sole Foot and Ankle Specialists PC

  • Foot & Ankle Surgery Podiatrist
  • Glendale, AZ
  • NPI 1710197272
  Medicare reassignment Care Compare group NPD
• Jerome a Cohn DPM PC

  • Podiatrist
  • Goodyear, AZ
  • NPI 1760413421
  Medicare reassignment NPD
• Jerome a Cohn, DPM, PC

  • Podiatrist
  • Goodyear, AZ
  • NPI 1740420264
  NPD
• Sole Foot and Ankle Specialists PC

  • Durable Medical Equipment & Medical Supplies
  • Glendale, AZ
  • NPI 1346354354

  Podiatrist

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner Gateway Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1699884858
  Care Compare affiliation

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1104267780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5432 E SOUTHERN AVE STE 101B",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062772",
            "telephone_number": "480-210-3336",
            "fax_number": "480-210-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5432 E SOUTHERN AVE STE 101B",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062772",
            "telephone_number": "480-210-3336",
            "fax_number": "480-210-3339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 S Dobson Rd",
            "address_2": "SUITE 307",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024725",
            "country_code": "US",
            "telephone_number": "480-844-8218",
            "fax_number": "480-800-6647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JACOB",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-11",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey E Nelson, M.S. OTR/L
• Destiny Nelson
• Ellie Nelson
• Erin Da Hye Nelson
• Jaclynn Marie Nelson, RD, CDE
• Jacquelyn Nelson, M.S.C
• John Andrew Nelson, P.A.-C
• Kylie Nelson
• Megan Nelson, RN
• Michela S. Nelson, NMD

• Foot & Ankle Surgery Podiatrist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Foot & Ankle Surgery Podiatrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.