NPIMap

Individual provider Active NPI

Jason N Zommick, M.D.

  • Specialist
  • Las Vegas, NV
National Provider Identifier
1255367553
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9752 Issued in NV
Practice address
5701 W. Charleston Blvd
Suite 201
Las Vegas, NV 89146
Phone
(702) 877-0814
Fax
(702) 877-3238
NPI assigned
Jun 25, 2006
Last updated
Mar 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9752 NV Primary

Addresses

Primary practice location

5701 W. Charleston Blvd
Suite 201
Las Vegas, NV 89146

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-0817

Other identifiers 2

IdentifierTypeStateIssuer
002018467MedicaidNV
340020382OtherRAILROAD MEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091230000551 NV Practitioner - Urology 5092856823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Warren Alpert Medical School of Brown University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group Rhodes P CGroup PAC ID 1052390036, 53 clinicians

Practice addresses (Care Compare)

58 N Pecos Rd
Henderson, NV 89074-7319
Phone (702) 877-0814

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.7 of 100Reported as group
Quality
82.63
Promoting interoperability
100
Improvement activities
40
Cost
83.03

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group Rhodes P C Specialist CurrentSince Aug 1, 2001 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Aug 1, 2001 Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients

Locations

58 N Pecos Rd
Henderson, NV 89074
Phone (702) 822-2000

1655 E Cactus Ave
Ste 4B
Las Vegas, NV 89183

5701 W Charleston Blvd
Ste 201
Las Vegas, NV 89146
Phone (702) 750-0313

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

Interoperability endpoints

  • Direct secure messaging: jason.zommick.p1@direct.usonv.nextgenshare.com
  • Direct secure messaging: jzommick119346@westdirect.optum.com

Organizations & group practices 3

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1255367553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-0817",
            "fax_number": "702-877-3238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 W. CHARLESTON BLVD",
            "address_2": "SUITE 201",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89146",
            "telephone_number": "702-877-0814",
            "fax_number": "702-877-3238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOMMICK",
        "first_name": "JASON",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "9752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018467",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "340020382",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.