NPIMap

Individual provider Active NPI

Mason Jahnke

  • Psychiatry Physician
  • Las Vegas, NV
National Provider Identifier
1457767246
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
21209 Issued in NV
Practice address
4000 E Charleston Blvd Ste 230
Las Vegas, NV 89104-6682
Phone
(702) 968-5000
Fax
(702) 968-5050
NPI assigned
Jul 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X T-3357 MS
Psychiatry Physician 2084P0800X 21209 NV Primary

Addresses

Primary practice location

4000 E Charleston Blvd Ste 230
Las Vegas, NV 89104-6682

Mailing address

3016 W Charleston Blvd Ste 100
Las Vegas, NV 89102-1973
Phone (702) 780-7118

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
I20210920002094 NV Practitioner - Psychiatry 1951675586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Oregon Health Sciences University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Practice addresses (Care Compare)

1707 W Charleston Blvd
Las Vegas, NV 89102-2352

4000 E Charleston Blvd
Suite 130
Las Vegas, NV 89104-6681
Phone (702) 968-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine CurrentSince Aug 1, 2021 Accepting new patients
Unlv Medicine Current Accepting new patients
Unlv Medicine CurrentSince Aug 1, 2021 Accepting new patients

Locations

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

4000 E Charleston Blvd
Ste 130
Las Vegas, NV 89104
Phone (702) 480-1031

3016 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 780-2315

1707 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 671-5070

4000 E Charleston Blvd
Ste 230
Las Vegas, NV 89104
Phone (702) 968-4000

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

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 and National Provider Directory roles.

Hospital & facility affiliations 12

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": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1457767246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021973",
            "telephone_number": "702-780-7118",
            "fax_number": "702-895-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 E CHARLESTON BLVD STE 230",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891046682",
            "telephone_number": "702-968-5000",
            "fax_number": "702-968-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAHNKE",
        "first_name": "MASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-01",
        "last_updated": "2022-07-21",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "T-3357",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "21209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.