MR. DYLAN SCOTT JACOBSEN DO
NPI 1346092848
Student in an Organized Health Care Education/Training Program in Nellis Afb, NV

Q: What is Dylan Jacobsen's NPI number?

The NPI number for Dylan Jacobsen is 1346092848. It was assigned to this individual provider in the NPPES registry on April 5, 2024.

Q: What is Dylan Jacobsen's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Dylan Jacobsen was last updated on March 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since April 05, 2024PECOS Enrolled

4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191(702) 653-2273 Get Directions Write a Review

NPPES record last updated: March 23, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 23, 2026, Aug 14, 2025, Apr 5, 2024 (3 updates tracked since 2024).

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About Mr. Dylan Scott Jacobsen Do NPPES

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

MR. DYLAN SCOTT JACOBSEN DO (NPI 1346092848) is an individual student in an organized health care education/training program in Nellis Afb, Nevada, licensed in Nevada (SL2481) and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS and maintains a secondary practice location in Richmond.

NPPES Registry Identity

NPI1346092848

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMR. DYLAN SCOTT JACOBSENCredential: DO

Location Address4700 LAS VEGAS BLVD NNellis Afb, NV 89191-6600

Mailing Address4700 Las Vegas Blvd NNellis Afb, NV 89191-6600 · (702) 653-2273

Phone(702) 653-2273

Sole ProprietorNo

Enumeration DateApril 5, 2024

Last NPPES UpdateMarch 23, 20263 updates tracked since enumeration

NPPES CertifiedMarch 23, 2026

✔ NPI 1346092848 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in NV · SL2481

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.

4700 LAS VEGAS BLVD N, Nellis Afb, NV 89191

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Secondary Practice Location 1

Location 11213 E Clay StRichmond, VA 23298-5071 · Phone (804) 828-0996

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Dylan Scott Jacobsen Do 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.

DR. DEBRA A KOENIGSBERGER MD

Integrative Medicine