Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. DYLAN SCOTT JACOBSEN DO
NPI 1346092848
Military Health Care Provider 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 Military Health Care Provider with taxonomy code 171000000X.

Q: When was this NPI record last updated?

The NPPES record for Dylan Jacobsen was last updated on August 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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: August 25, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 25, 2026, Mar 23, 2026, Aug 14, 2025 and 1 more (4 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 military health care provider provider 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 Taxonomy171000000X

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 UpdateAugust 25, 20264 updates tracked since enumeration

NPPES CertifiedAugust 25, 2026

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

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care ProviderOther Service Providers

Taxonomy Code171000000X

License✔ Licensed in NV · SL2481

Definition

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

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