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DR. JACOB JUN TSUKAMOTO
NPI 1083180798
Student in an Organized Health Care Education/Training Program in Layton, UT

Active since October 19, 2018PECOS Enrolled
934 S MAIN ST, LAYTON, UT 84041(801) 336-1845 Get Directions Write a Review

NPPES record last updated: May 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 27, 2026, Dec 29, 2025, Oct 19, 2018 (3 updates tracked since 2018).

About Dr. Jacob Jun Tsukamoto NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACOB JUN TSUKAMOTO (NPI 1083180798) is an individual student in an organized health care education/training program in Layton, Utah, licensed in Idaho (7481707) and active in the NPI registry since October 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083180798
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. JACOB JUN TSUKAMOTO
Location Address934 S MAIN STLayton, UT 84041-7135
Mailing Address934 S Main StLayton, UT 84041-7135 · (801) 336-1845
Phone(801) 336-1845
Sole ProprietorNo
Enumeration DateOctober 19, 2018
Last NPPES UpdateMay 27, 20263 updates tracked since enumeration
NPPES CertifiedMay 27, 2026
✔ NPI 1083180798 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in ID · 7481707
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedCommunity Health WorkerTaxonomy 172V00000X
934 S MAIN ST, Layton, UT 84041
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jacob Jun Tsukamoto is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TREVOR CRAIG SAVAGE
Technician, Other
934 S MAIN ST
LAYTON, UT 84041
Davis County (801) 546-1168
GREG MOSS
Technician, Other
934 S MAIN ST
LAYTON, UT 84041
Davis County (801) 773-7060
KELLEY DIANE IRMEN
Social Worker (Clinical)
934 S MAIN ST
LAYTON, UT 84041
Davis County (801) 773-7060
JASON ADAMS
Community Health Worker
934 S MAIN ST
LAYTON, UT 84041
Davis County (801) 773-3060
KELSEE WANDLING
Technician, Other
934 S MAIN ST
LAYTON, UT 84041
Davis County (801) 773-7060
MICHAEL M LEBARON
Case Manager/Care Coordinator
934 S MAIN ST
LAYTON, UT 84041
Davis County (801) 773-7060
NATALIE JO COLVIN
Case Manager/Care Coordinator
934 S MAIN ST
LAYTON, UT 84041
Davis County (801) 773-7060
ROBERT SAMUEL CLARK
Community Health Worker
934 S MAIN ST
LAYTON, UT 84041
Davis County (801) 336-1845

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Tsukamoto's NPI number?

The NPI number for Jacob Tsukamoto is 1083180798. It was assigned to this individual provider in the NPPES registry on October 19, 2018.

Where is Jacob Tsukamoto located?

Jacob Tsukamoto practices at 934 S Main St, Layton, UT 84041. The listed phone number is (801) 336-1845.

What is Jacob Tsukamoto's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jacob Tsukamoto enrolled in Medicare?

Yes. Jacob Tsukamoto is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Tsukamoto was last updated on May 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.