Individual provider Active NPI

Jason Valderrama, PA-C

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1063814358
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4125 Issued in CO
Practice address
14300 E Exposition Ave
Aurora, CO 80012-2542
Phone
(720) 853-4230
Fax
(303) 745-4832
NPI assigned
Sep 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4125 CO Primary

Addresses

Primary practice location

14300 E Exposition Ave
Aurora, CO 80012-2542

Mailing address

12439 E Harvard Dr
Aurora, CO 80014-1923
Phone (970) 217-6958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141230001694 CO Practitioner - Physician Assistant 1355664285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Community Health CurrentSince Oct 27, 2014 Accepting new patients
Community Medical Services Montana Private LLC CurrentSince Aug 21, 2023 Accepting new patients
Sunrise Community Health Past Accepting new patients

Locations

2930 11th Ave
Evans, CO 80620
Phone (970) 350-4606

302 3rd St SE
Ste 150
Loveland, CO 80537
Phone (970) 669-4855

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1063814358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12439 E HARVARD DR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141923",
            "telephone_number": "970-217-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 E EXPOSITION AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800122542",
            "telephone_number": "720-853-4230",
            "fax_number": "303-745-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDERRAMA",
        "first_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-18",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "4125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.