Individual provider Active NPI

Kameron Jacobson, PT

  • Neurology Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1326701822
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology Physical TherapistTaxonomy code 2251N0400X
License
4539 Issued in NV
Practice address
888 W Bonneville Ave
Las Vegas, NV 89106-0100
Phone
(702) 483-6032
NPI assigned
Oct 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physical Therapist 2251N0400X 4539 NV Primary

Addresses

Primary practice location

888 W Bonneville Ave
Las Vegas, NV 89106-0100

Mailing address

888 W Bonneville Ave
Las Vegas, NV 89106-0100
Phone (702) 483-6032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230925001905 NV Practitioner - Physical Therapist in Private Practice 6103270178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Nevada, Las Vegas School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland Clinic NevadaGroup PAC ID 9537219431, 31 clinicians

Practice addresses (Care Compare)

888 W Bonneville Ave
Las Vegas, NV 89106-0100
Phone (702) 483-6000

Merit-based Incentive Payment System (MIPS)

Final score
78.72 of 100Reported as group
Quality
56.4
Promoting interoperability
100
Improvement activities
40
Cost
72.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4539NVMDNeurology Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Nevada Physical Therapist CurrentSince Aug 9, 2023 Accepting new patients

Locations

888 W Bonneville Ave
Las Vegas, NV 89106
Phone (702) 263-9797

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 1

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": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1326701822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 W BONNEVILLE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891060100",
            "telephone_number": "702-483-6032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 W BONNEVILLE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891060100",
            "telephone_number": "702-483-6032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "KAMERON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-21",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "NV",
            "license": "4539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.