MEDICARE: JAY MICHAEL MARCOS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	896143	NV

General Provider Information

NPI Number	:	1932050044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY MICHAEL MARCOS

Provider Business Mailing Address
First Line	:	6564 POLONIUS CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-8591
Country	:	US
Telephone Number	:	310-748-3050
Fax Number	:	310-748-3050

Provider Business Practice Location Address
First Line	:	6564 POLONIUS CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-8591
Country	:	US
Telephone Number	:	310-748-3050
Fax Number	:	310-748-3050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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