Individual provider Active NPI

Jason A Jergensen, DO

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1255890968
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A24738 Issued in CA
Practice address
Navy Medicine Branch Clinic-MCRD 35000 Guadal Canal Ave
San Diego, CA 92140-0001
Phone
(619) 524-8484
NPI assigned
Mar 13, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0102206319 VA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 20A24738 CA Primary

Addresses

Primary practice location

Navy Medicine Branch Clinic-MCRD 35000 Guadal Canal Ave
San Diego, CA 92140-0001

Mailing address

Naval Medical Center San Diego 34800 Bob Wilson Drive
San Diego, CA 92134-0001
Phone (619) 532-6400

Other practice location 1

Naval Medical Center San Diego 34800 Bob Wilson Drive
San Diego, CA 92134-0001
Phone (619) 532-6400

Other practice location 2

Naval Medical Center Portsmouth
620 John Paul Jones Circle
Portsmouth, VA 23708
Phone (757) 953-2518

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260617004002 CA Practitioner - Family PracticePractitioner - Other (Physician) 2466924758 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jurkowski Medical CorporationGroup PAC ID 7911155304, 16 clinicians
Two Zeds Medical CorporationGroup PAC ID 7810291291, 14 clinicians

Practice addresses (Care Compare)

10605 Scripps Poway Pkwy
Suite Bandc
San Diego, CA 92131-3925
Phone (858) 622-0554

3830 Valley Centre Dr
San Diego, CA 92130-3307
Phone (858) 720-0554

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A24738CAMDFamily Medicine Physician
0102206319VAMDGeneral Practice Physician

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1255890968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER SAN DIEGO 34800 BOB WILSON DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921340001",
            "telephone_number": "619-532-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVY MEDICINE BRANCH CLINIC-MCRD 35000 GUADAL CANAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921400001",
            "telephone_number": "619-524-8484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Naval Medical Center San Diego 34800 Bob Wilson Drive",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921340001",
            "country_code": "US",
            "telephone_number": "619-532-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Naval Medical Center Portsmouth",
            "address_2": "620 John Paul Jones Circle",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "23708",
            "country_code": "US",
            "telephone_number": "757-953-2518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JERGENSEN",
        "first_name": "JASON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-13",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102206319",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A24738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.