Jason Lynn Nelles, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

A125671 Issued in CA

Practice address

3501 Palmer Dr
Suite 201
Cameron Park, CA 95682-8276

Phone

(530) 626-9488

NPI assigned

Jul 26, 2007

Last updated

Jan 27, 2014By the provider in NPPES

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 CA

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

Specialty

Urology

Education

Washington University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshall Medical Center Hospital, Placerville, CA, CCN 050254
• Sutter Amador Hospital Hospital, Jackson, CA, CCN 050014

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Marshall Medical Center

  • Family Medicine Physician
  • El Dorado Hills, CA
  • NPI 1114727377
  Medicare reassignment Care Compare group NPD
• Marshall Medical Center

  dba Marshall ENT

  • Otolaryngology Physician
  • Placerville, CA
  • NPI 1578872784
  NPD
• Marshall Medical Center

  dba Marshall Home Care

  • Home Health Agency
  • Diamond Springs, CA
  • NPI 1992705040
  NPD (past)

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

• Marshall Medical Center

  • General Acute Care Hospital
  • Placerville, CA
  • NPI 1972503142
  Care Compare affiliation
• Sutter Valley Hospitals

  dba Sutter Amador Hospital

  • General Acute Care Hospital
  • Jackson, CA
  • NPI 1447494323
  Care Compare affiliation

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1164612024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45680",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941450680",
            "telephone_number": "530-626-9488",
            "fax_number": "530-748-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 PALMER DR",
            "address_2": "SUITE 201",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956828276",
            "telephone_number": "530-626-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLES",
        "first_name": "JASON",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A125671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margarita Miyasato
• Swetha Mudunuri, M.D.,
• Erin Mullins, PHARMD
• MV Perera Licensed Clinical Social Worker, Inc.
• Marisa Larae Neeley, PA-C
• Devin Nelson, LMFT
• New Morning Youth & Family Services, Inc
• Linda Nghiem
• Jenny Diep Nguyen, PHARMD
• Thu Nguyen

• Urology Physician in Cameron Park, CA
• Providers in Cameron Park, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.