| Jacob Riis, MD | |
| 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | |
| (702) 653-2273 | |
| Not Available | 
| Full Name | Jacob Riis | 
|---|---|
| Gender | Male | 
| Speciality | Orthopaedic Surgery | 
| Location | 4700 Las Vegas Blvd N, Nellis Afb, Nevada | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1043417611 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 69060 (Arizona) | Secondary | 
| 207X00000X | Orthopaedic Surgery | ME 103069 (Florida) | Primary | 
| Entity Name | Kingman Healthcare Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1265423917 PECOS PAC ID: 6901791367 Enrollment ID: O20040216001173 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Jacob Riis, MD 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 Ph: (702) 653-2273 | Jacob Riis, MD 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 Ph: (702) 653-2273 | 
| Kartik Shenoy, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-3040 | |
| Alexander J Mayers, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-2273 | |
| Andrew Scott Watkins, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-2273 | |
| Dr. Brandon Mark Bennett, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-652-2273 | |
| Andrew Haus,  Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-2273 | |
| Dr. Colin D Kennedy, M.D. Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 Phone: 702-653-3040 |