Active NPI
Jennifer Lee Depry, D.O.
- Dermatology Physician
- Las Vegas, NV
National Provider Identifier
1619260122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 2157
- Practice address
- 1250 S Buffalo Dr Ste 170
Las Vegas, NV 89117-8329 - Phone
- (702) 255-7924
- NPI assigned
- May 17, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 2157 | NV | Primary |
| Dermatology Physician | 207N00000X | 20A14883 | CA |
Addresses
Primary practice location
1250 S Buffalo Dr Ste 170
Las Vegas, NV 89117-8329
Mailing address
9097 W Post Rd
Ste 100
Las Vegas, NV 89148-2417
Phone (702) 430-5333
Other practice location 1
4060 Fourth Ave Ste 415
San Diego, CA 92103-2121
Phone (619) 298-9809
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Kansas City University of Physicians and Surgeons, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9097 W Post Rd
Suite 100
Las Vegas, NV 89148-2417
Phone (702) 430-5333
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 33 |
| Removal of skin lesions | 1-10 |
| Removal of skin cancer | 385 |
| Removal of nail tissue | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2157 | NV | MD | Dermatology Physician |
| 14883 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scripps Health | Current | Accepting new patients | |
| J. Robert West, M.D., Inc | Dermatology | Past | Accepting new patients |
| Douglas a. Thomas, MD | Dermatology | Past | Accepting new patients |
Interoperability endpoints
- jdepry@thomasderm.emadirect.md
- jdepry80949@scrippshlth.medalliesdirect.net
Organizations & group practices 4
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.
-
- Dermatology Physician
- Las Vegas, NV
- NPI 1922279496
-
dba Scripps Hospital Medical Services
- General Acute Care Hospital
- San Diego, CA
- NPI 1487928891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581292800000",
"number": "1619260122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9097 W POST RD",
"address_2": "STE 100",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891482417",
"telephone_number": "702-430-5333",
"fax_number": "702-430-5335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 S BUFFALO DR STE 170",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891178329",
"telephone_number": "702-255-7924"
}
],
"practiceLocations": [
{
"address_1": "4060 Fourth Ave Ste 415",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921032121",
"country_code": "US",
"telephone_number": "619-298-9809",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEPRY",
"first_name": "JENNIFER",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-17",
"last_updated": "2020-02-10",
"certification_date": "2020-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NV",
"license": "2157",
"primary": true
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "20A14883",
"primary": false
}
],
"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 Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.