NPIMap

Individual provider Active NPI

Michelle Marie Jakoby

  • Physician Assistant
  • Reno, NV
National Provider Identifier
1407547722
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5560 Kietzke LN BLDG a
Reno, NV 89511-3019
Phone
(775) 322-7811
Fax
(775) 322-1431
NPI assigned
May 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

5560 Kietzke LN BLDG a
Reno, NV 89511-3019

Mailing address

5560 Kietzke LN BLDG a
Reno, NV 89511-3019
Phone (775) 322-7811

Other practice location 1

5070 Ion Dr Ste 201
Sparks, NV 89436-1612
Phone (775) 322-7811

Other practice location 2

1820 Kings Row
Reno, NV 89503-2216
Phone (415) 694-0486

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
I20241111003649 NV Practitioner - Physician Assistant 0840724068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nevada School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology Nevada LTDGroup PAC ID 1557460557, 24 clinicians

Practice addresses (Care Compare)

5560 Kietzke LN
BLDG a
Reno, NV 89511-3019
Phone (775) 322-7811

Hospital & facility affiliations

  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
  • Northern Nevada Medical Center Hospital, Sparks, NV, CCN 290032
  • Renown South Meadows Medical Center Hospital, Reno, NV, CCN 290049
  • Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019
  • Saint Mary'S Regional Medical Center Hospital, Reno, NV, CCN 290009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Nevada LTD CurrentSince Oct 1, 2024 Accepting new patients

Locations

5560 Kietzke Ln
Bldg A
Reno, NV 89511
Phone (775) 322-7811

10745 Double R Blvd
Reno, NV 89521
Phone (775) 322-7811

5070 Ion Dr
Ste 201
Sparks, NV 89436
Phone (775) 322-7811

Interoperability endpoints

  • Direct secure messaging: michelle.jakoby.1@19482.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19482/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1407547722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5560 KIETZKE LN BLDG A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113019",
            "telephone_number": "775-322-7811",
            "fax_number": "775-322-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5560 KIETZKE LN BLDG A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895113019",
            "telephone_number": "775-322-7811",
            "fax_number": "775-322-1431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5070 Ion Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Sparks",
            "state": "NV",
            "postal_code": "894361612",
            "country_code": "US",
            "telephone_number": "775-322-7811",
            "fax_number": "775-322-1431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1820 Kings Row",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895032216",
            "country_code": "US",
            "telephone_number": "415-694-0486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAKOBY",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-17",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.