NPIMap

Individual provider Active NPI

John S Jachimiak, DPM

  • Foot & Ankle Surgery Podiatrist
  • Boulder, CO
National Provider Identifier
1043227390
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
CO 526 Issued in CO
Practice address
2575 Pearl St
Suite 240
Boulder, CO 80302-3851
Phone
(303) 442-2910
Fax
(303) 442-2931
NPI assigned
Aug 1, 2006
Last updated
Nov 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X CO 526 CO
Sports Medicine Podiatrist 213ES0000X CO 526 CO
Foot & Ankle Surgery Podiatrist 213ES0103X CO 526 CO Primary
Foot & Ankle Surgery Podiatrist 213ES0103X CO526 CO

Addresses

Primary practice location

2575 Pearl St
Suite 240
Boulder, CO 80302-3851

Mailing address

2575 Pearl St
Suite 240
Boulder, CO 80302-3851
Phone (303) 442-2910

Other identifiers 1

IdentifierTypeStateIssuer
01005263MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090828000181 CO Practitioner - Podiatry 8325030539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder County Foot and Ankle, PCGroup PAC ID 6406901305, 3 clinicians

Practice addresses (Care Compare)

2575 Pearl St
Suite 240
Boulder, CO 80302-3851
Phone (303) 888-6173

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue111
Removal of skin lesions1-10
Removal of nail tissue31
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CO 526COMDSports Medicine Podiatrist
CO526COMDFoot & Ankle Surgery Podiatrist
526COMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pearl Podiatry Health Center, LLC PastSince Jul 16, 2009 Accepting new patients
Neuropathy Center of Boulder County, LLC Podiatrist Past Accepting new patients
Foot and Ankle Care of Boulder County, LLC Foot & Ankle Surgery PastSince Nov 1, 1999 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: john.jachimiak@bcfaa-co.direct.office.nextgen.com
  • Direct secure messaging: johnjachimiakdpm@bouldercounty.direct.emds.com

Organizations & group practices 4

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.

Hospital & facility affiliations 35

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1043227390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 PEARL ST",
            "address_2": "SUITE 240",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803023851",
            "telephone_number": "303-442-2910",
            "fax_number": "303-442-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 PEARL ST",
            "address_2": "SUITE 240",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803023851",
            "telephone_number": "303-442-2910",
            "fax_number": "303-442-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACHIMIAK",
        "first_name": "JOHN",
        "middle_name": "S",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CO",
            "license": "CO 526",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "CO",
            "license": "CO 526",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "CO 526",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "CO526",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01005263",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.