NPIMap

Individual provider Active NPI

Jason W David, MD

  • Emergency Medicine Physician
  • Nellis Afb, NV
National Provider Identifier
1619473204
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
1026680 Issued in MA
Practice address
4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Phone
(702) 653-2344
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21143 NV
Emergency Medicine Physician 207P00000X 1026680 MA Primary
Emergency Medicine Physician 207P00000X 2114 NV
Emergency Medicine Physician 207P00000X 32129 NE

Addresses

Primary practice location

4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600

Mailing address

960 Massachusetts Ave Ste 2
Boston, MA 02118-2690
Phone (617) 414-4505

Other practice location 1

736 Cambridge St Connell Pavillion
Brighton, MA 02135
Phone (617) 789-2666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211115002458 NV Practitioner - Emergency Medicine 1759632052 Reassigns benefits to 4 organizations
I20260611002725 MA Practitioner - Emergency Medicine 1759632052

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shadow Emergency Physicians PLLCGroup PAC ID 2860667375, 105 clinicians

Practice addresses (Care Compare)

620 Shadow LN
Las Vegas, NV 89106-4119
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32129NEMDEmergency Medicine Physician
21143NVMDEmergency Medicine Physician
2114NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fremont Emergency Services Scherr LTD Emergency Medicine Current Accepting new patients
University Medical Center of Southern Nevada CurrentSince Jul 1, 2024 Accepting new patients
Fremont Emergency Services Scherr LTD Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
Fremont Emergency Services Scherr LTD Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
Sound Physicians Emergency Medicine of Nevada Bessler PLLC Emergency Medicine CurrentSince Nov 1, 2021 Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Aug 1, 2021 Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Aug 1, 2021 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Jul 1, 2024 Accepting new patients

Locations

1050 W Galleria Dr
Henderson, NV 89011
Phone (702) 723-4124

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

3186 S Maryland Pkwy
Ste 410
Las Vegas, NV 89109

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

Organizations & group practices 8

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 7

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1619473204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690",
            "telephone_number": "617-414-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "736 Cambridge St Connell Pavillion",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "02135",
            "country_code": "US",
            "telephone_number": "617-789-2666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVID",
        "first_name": "JASON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "21143",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "1026680",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "2114",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "32129",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nellis Afb, NV

Sources for this page

Verify at the official NPI Registry.