Jon F Depolo, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA807 Issued in NV

Practice address

620 Shadow LN
Las Vegas, NV 89106-4119

Phone

(702) 388-4500

NPI assigned

May 25, 2006

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 NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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 and National Provider Directory roles.

• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1043030919

  Physician Assistant

  NPD
• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Henderson, NV
  • NPI 1487496998
  NPD
• Nevada Em-I Silver-Homansky Medical Services Professional Corporation

  • Emergency Medicine Physician
  • Pahrump, NV
  • NPI 1881932721
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1245286038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9941 LIBERTY VIEW RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485507",
            "telephone_number": "702-597-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064119",
            "telephone_number": "702-388-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPOLO",
        "first_name": "JON",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dependable Home Health of Nevada LLC
• Dependable Home Health of Nevada LLC
• Dependable Medical Solutions LLC
• Mark Depew
• Marsha Leigh Depew, RN
• Brandy Depoorter, PHARMD
• Muriel Deppner
• Stacy S Depriest, LCSW
• Jennifer Lee Depry, D.O.
• Depth Psychological Services

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; 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.