JACOB VINSON
NPI 1396339974
Physician Assistant - Surgical in Fresno, CA

Q: What is Jacob Vinson's NPI number?

The NPI number for Jacob Vinson is 1396339974. It was assigned to this individual provider in the NPPES registry on February 24, 2021.

Q: What is Jacob Vinson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Vinson was last updated on August 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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 February 24, 2021PECOS EnrolledAccepts Medicare Assignment

85/100

CMS Quality Rating

2823 FRESNO ST, FRESNO, CA 93721(559) 459-5194(559) 459-3719 Get Directions Write a Review

NPPES record last updated: August 5, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 5, 2021, Feb 24, 2021 (2 updates tracked since 2021).

On this page

About Jacob Vinson NPPES

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

JACOB VINSON (NPI 1396339974) is an individual surgical provider in Fresno, California, licensed in California (59205) and active in the NPI registry since February 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1396339974

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameJACOB VINSON

Location Address2823 FRESNO STFresno, CA 93721-1324

Mailing Address2625 E Divisadero StFresno, CA 93721-1431 · (559) 443-2682 · Fax (559) 443-2681

Phone(559) 459-5194

Fax(559) 459-3719

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateFebruary 24, 2021

Last NPPES UpdateAugust 5, 20212 updates tracked since enumeration

NPPES CertifiedAugust 5, 2021

✔ NPI 1396339974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in CA · 59205

Also ListedPhysician AssistantTaxonomy 363A00000X · License 59205 (CA)

2823 FRESNO ST, Fresno, CA 93721

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacob Vinson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991106882

PECOS Enrollment IDI20210629003691

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

85/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

81.33

Promoting Interoperability

100

Improvement Activities

Cost

45.02

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.

MICHELLE LEA STORKAN M.D.

Emergency Medicine