JACOB A PARKS (PA) – Physician Assistant, NPI 1073114906

JACOB A PARKS (PA) is a healthcare provider. based in Las vegas, Nevada. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA0492 (NV). The NPI Number for JACOB A PARKS (PA) is 1073114906

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
JACOB A PARKS (PA)
NPI
1073114906
Phone
(702) 877-5199
Address
PO BOX 35380
Enumeration Date
6 November 2020
Last Update Date
14 January 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7025793253
Graduation Year
2020 (6 years ago)
PAC ID
6608281415
Group Practice PAC ID
4981687779
Professional Enrollment ID
I20210208002879
Address ID
NV891197826LA4475XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,223 PHYSICIAN ASSISTANT in NV

Provider Addresses for JACOB A PARKS (PA)

  • PO BOX 35380

    LAS VEGAS, NV 891335380

    Phone: (702) 877-5199

    Type: Mailing

  • 4475 S EASTERN AVE

    LAS VEGAS, NV 891197826

    Phone: (702) 877-5199

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-03-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210208002879IPhysician AssistantNVTBD
I20260303003778IPhysician AssistantIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes6633$0
99213Established patient office or other outpatient visit, 20-29 minutes1311$0
View full utilization report →

Insurance plans in this area (ZIP 89133)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4981687779View full group profile
NameSpecialtyState
Family PracticeTX
Internal MedicineNV
Physician AssistantNV
-KY
Nurse PractitionerNV
-NV
Nurse PractitionerNV
O B S T E T R I C S/ G Y N E C O L O G YNV
Nurse PractitionerIL
-NV

Reviews

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Frequently asked questions

What NPI should I save for JACOB A PARKS (PA)?
Save NPI 1073114906 if you need a stable reference for JACOB A PARKS (PA).
Is JACOB A PARKS (PA) currently active in the NPI registry?
CMS-published data lists JACOB A PARKS (PA) as an active registrant.
What kind of provider is JACOB A PARKS (PA)?
The page reflects Physician Assistant for JACOB A PARKS (PA). Clinical services aligned with this taxonomy classification.
What location shows for JACOB A PARKS (PA)?
We surface Las Vegas, Nevada for JACOB A PARKS (PA) based on available NPPES addresses.
What if Las Vegas, Nevada seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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