Individual provider Active NPI

Jake Gifford

  • Medical Physician Assistant
  • Henderson, NV
National Provider Identifier
1922675321
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA3131 Issued in NV
Practice address
3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Phone
(702) 616-5615
Fax
(702) 616-5120
NPI assigned
Jun 6, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA3131 NV Primary

Addresses

Primary practice location

3001 Saint Rose Pkwy
Henderson, NV 89052-3839

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786

Other practice location 1

8280 W Warm Springs Rd
Las Vegas, NV 89113-3612
Phone (702) 492-8614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210811004008 FL Practitioner - Physician Assistant 3476957572 Reassigns benefits to 1 organization
I20250728003476 NV Practitioner - Physician Assistant 3476957572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical Group Nevada LLCGroup PAC ID 1254571896, 127 clinicians

Practice addresses (Care Compare)

8689 W Charleston Blvd
Suite 105
Las Vegas, NV 89117-5485
Phone (702) 304-5900

Hospital & facility affiliations

  • Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jul 23, 2021 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 23, 2021 Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1600 SW Archer Rd
#100286
Gainesville, FL 32610
Phone (352) 265-0761

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 1

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": "1622937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1922675321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 SAINT ROSE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523839",
            "telephone_number": "702-616-5615",
            "fax_number": "702-616-5120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8280 W Warm Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891133612",
            "country_code": "US",
            "telephone_number": "702-492-8614",
            "fax_number": "702-492-8163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIFFORD",
        "first_name": "JAKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-06",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA3131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.