Individual provider Active NPI

Jesse Sheldon, PA-C

  • Physician Assistant
  • Lakewood, CO
National Provider Identifier
1073140190
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0006916 Issued in CO
Practice address
165 S Union Blvd Ste 400
Lakewood, CO 80228-2219
Phone
(303) 351-5995
Fax
(720) 925-5897
NPI assigned
Mar 26, 2020
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA.0006916 CO Primary

Addresses

Primary practice location

165 S Union Blvd Ste 400
Lakewood, CO 80228-2219

Mailing address

5445 DTC Pkwy Ste 1130
Greenwood Village, CO 80111-3038
Phone (720) 749-5599

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
I20220927003527 CO Practitioner - Physician Assistant 1850712019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Pain SpecialistsGroup PAC ID 7911255013, 53 clinicians

Practice addresses (Care Compare)

10375 Park Meadows Dr
Suite 270
Lone Tree, CO 80124-6760
Phone (720) 749-5599

15901 E Briarwood Cir
Unit 150
Aurora, CO 80016-1787
Phone (303) 645-4363

Merit-based Incentive Payment System (MIPS)

Final score
30.58 of 100Reported as group
Quality
9.59
Promoting interoperability
0
Improvement activities
0
Cost
68.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0006916COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Pain Center CurrentSince Nov 3, 2024 Accepting new patients

Locations

15901 E Briarwood Cir
Unit 150
Aurora, CO 80016
Phone (303) 645-4363

5445 Dtc Pkwy
Ste 1130
Greenwood Village, CO 80111

165 S Union Blvd
Ste 400
Lakewood, CO 80228
Phone (303) 351-5995

10375 Park Meadows Dr
Ste 270
Lone Tree, CO 80124
Phone (303) 351-5995

Interoperability endpoints

  • Direct secure messaging: jesse.sheldon@3675.securemail.prognocis.com

Organizations & group practices 2

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1073140190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 DTC PKWY STE 1130",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113038",
            "telephone_number": "720-749-5599",
            "fax_number": "720-925-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S UNION BLVD STE 400",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282219",
            "telephone_number": "303-351-5995",
            "fax_number": "720-925-5897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELDON",
        "first_name": "JESSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.