Individual provider Active NPI

Jason Donald Main, DPT

  • Physical Therapist
  • Longmont, CO
National Provider Identifier
1023272747
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0012499 Issued in CO
Practice address
1610 Dry Creek Dr
Longmont, CO 80503-6405
Phone
(720) 494-4750
Fax
(720) 494-4751
NPI assigned
Jul 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PTL.0012499 CO Primary

Addresses

Primary practice location

1610 Dry Creek Dr
Longmont, CO 80503-6405

Mailing address

2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone (970) 493-0112

Other practice location 1

4924 Campbell Blvd
Suite 130-A
Baltimore, MD 21236-5908
Phone (443) 442-2050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150807015462 CO Practitioner - Physical Therapist in Private Practice 4183938822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1610 Dry Creek Dr
Longmont, CO 80503-6405
Phone (303) 772-1600

2420 E Prospect Rd
Fort Collins MRI
Fort Collins, CO 80525-9718
Phone (970) 493-0567

2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone (970) 493-4010

Merit-based Incentive Payment System (MIPS)

Final score
74.72 of 100Reported as group
Quality
70.39
Promoting interoperability
71
Improvement activities
40
Cost
69.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0012499COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic & Spine Center of the Rockies PC Single Specialty CurrentSince Mar 12, 2020 Accepting new patients

Locations

2500 E Prospect Rd
Fort Collins, CO 80525
Phone (800) 722-7441

300 Exempla Cir
Ste 170
Lafayette, CO 80026
Phone (720) 494-4750

1610 Dry Creek Dr
Longmont, CO 80503
Phone (720) 494-4750

1610 Dry Creek Dr
Ste 200
Longmont, CO 80503
Phone (303) 722-1600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1023272747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E PROSPECT RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259718",
            "telephone_number": "970-493-0112",
            "fax_number": "970-493-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 DRY CREEK DR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805036405",
            "telephone_number": "720-494-4750",
            "fax_number": "720-494-4751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4924 Campbell Blvd",
            "address_2": "Suite 130-A",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212365908",
            "country_code": "US",
            "telephone_number": "443-442-2050",
            "fax_number": "443-442-2054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAIN",
        "first_name": "JASON",
        "middle_name": "DONALD",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0012499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.