NPIMap

Individual provider Active NPI

Marc D Jeser, DO

  • Emergency Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1750337531
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
970 Issued in NV
Practice address
620 Shadow LN
Las Vegas, NV 89106-4119
Phone
(702) 388-4500
NPI assigned
May 25, 2006
Last updated
Dec 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 970 NV Primary

Addresses

Primary practice location

620 Shadow LN
Las Vegas, NV 89106-4119

Mailing address

9321 Fontainbleu Dr
Las Vegas, NV 89145-8653
Phone (702) 610-3905

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
I20041012000118 NV Practitioner - Emergency Medicine 1658330980 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 1996
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

Merit-based Incentive Payment System (MIPS)

Final score
58.42 of 100Reported as individual
Quality
58.12
Improvement activities
0
Cost
68.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
970NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Nov 1, 2011 Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Nov 1, 2011 Accepting new patients
Nevada Emergency Physicians PLLC Emergency Medicine Current Accepting new patients
Nevada Emergency Physicians PLLC Emergency Medicine CurrentSince Sep 12, 2024 Accepting new patients
Nevada Emergency Physicians PLLC Emergency Medicine CurrentSince Sep 12, 2024 Accepting new patients
Nopah Vista Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Twin Valley Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Emcare Physician Providers Inc Emergency Medicine Past Accepting new patients
Webster Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

2075 E Flamingo Rd
Las Vegas, NV 89119
Phone (702) 369-7613

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

6900 N Durango Dr
Las Vegas, NV 89149
Phone (702) 380-1964

6500 Longley Ln
Reno, NV 89511
Phone (775) 331-7000

2375 E Prater Way
Sparks, NV 89434
Phone (775) 331-7000

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1750337531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9321 FONTAINBLEU DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891458653",
            "telephone_number": "702-610-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064119",
            "telephone_number": "702-388-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESER",
        "first_name": "MARC",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.