Active NPI
Jason S McKenzie, DO
- Family Medicine Physician
- Sparks, NV
National Provider Identifier
1922085265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 873
- Practice address
- 480 E Prater Way
Sparks, NV 89431-4679 - Phone
- (775) 351-1300
- Fax
- (775) 351-1344
- NPI assigned
- Dec 28, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 873 | NV | Primary |
Addresses
Primary practice location
480 E Prater Way
Sparks, NV 89431-4679
Mailing address
480 E Prater Way
Sparks, NV 89431-4679
Phone (775) 351-1300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002016747 | Medicaid | NV |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100506000904 | NV | Practitioner - Family Practice | 7810025129 | Practice locations: Sparks, NV |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
480 E Prater Way
Sparks, NV 89431-4679
Phone (775) 351-1300
Hospital & facility affiliations
- Centerwell Home Health
- Renown Regional Medical Center
- Northern Nevada Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 24.41 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 81.37
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 19 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 873 | NV | MD | Family Medicine Physician |
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Reno, NV
- NPI 1285661108
-
- General Acute Care Hospital
- Reno, NV
- NPI 1124098421
-
- General Acute Care Hospital
- Sparks, NV
- NPI 1932517299
-
- General Acute Care Hospital
- Sparks, NV
- NPI 1548250582
-
- General Acute Care Hospital
- Reno, NV
- NPI 1609451327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501113600000",
"number": "1922085265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "480 E PRATER WAY",
"city": "SPARKS",
"state": "NV",
"postal_code": "894314679",
"telephone_number": "775-351-1300",
"fax_number": "775-351-1344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 E PRATER WAY",
"city": "SPARKS",
"state": "NV",
"postal_code": "894314679",
"telephone_number": "775-351-1300",
"fax_number": "775-351-1344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENZIE",
"first_name": "JASON",
"middle_name": "S",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-28",
"last_updated": "2017-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "873",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002016747",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sparks, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; 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.