JERRY ANN BALBOA GUMABON
NPI 1407651219
Nurse Practitioner - Family in Las Vegas, NV

Active since February 17, 2025PECOS EnrolledAccepts Medicare Assignment
5216 BOULDER HWY, LAS VEGAS, NV 89122(702) 547-6764 Get Directions Write a Review

NPPES record last updated: June 14, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 14, 2025, Jun 7, 2025, Feb 17, 2025 (3 updates tracked since 2025).

About Jerry Ann Balboa Gumabon NPPES

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

JERRY ANN BALBOA GUMABON (NPI 1407651219) is an individual family provider in Las Vegas, Nevada, licensed in Nevada (824950) and active in the NPI registry since February 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1407651219
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJERRY ANN BALBOA GUMABON
Location Address5216 BOULDER HWYLas Vegas, NV 89122-6074
Mailing Address5216 Boulder HwyLas Vegas, NV 89122-6074 · (702) 547-6764
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateFebruary 17, 2025
Last NPPES UpdateJune 14, 20253 updates tracked since enumeration
NPPES CertifiedJune 14, 2025
NPI 1407651219 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in NV · 824950
5216 BOULDER HWY, Las Vegas, NV 89122

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

Jerry Ann Balboa Gumabon 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 ID4284145491
PECOS Enrollment IDI20250616001204
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89122 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.51 typical visit price
range $57.07 – $173.24
Typical copayment $22.12 (range $14.26 – $43.31)
Most-billed visit code 99203
Established Patient
$100.60 typical visit price
range $18.27 – $140.96
Typical copayment $25.15 (range $4.56 – $35.24)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

Emergency Medicine
5216 BOULDER HWY, SUITE 105
LAS VEGAS, NV 89122
Nurse Practitioner (Family)
5216 BOULDER HWY
LAS VEGAS, NV 89122

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407651219, enumerated as an "individual" on February 17, 2025.

The provider is located at 5216 BOULDER HWY LAS VEGAS, NV 89122 and the phone number is (702) 547-6764.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.