NPIMap

Individual provider Active NPI

Jeremy Bradley Smith, PA-C

  • Surgical Physician Assistant
  • Aurora, CO
National Provider Identifier
1073666194
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0003431 Issued in CO
Practice address
12605 E 16TH Ave
Aurora, CO 80045-2545
Phone
(303) 493-7000
NPI assigned
Jan 19, 2007
Last updated
Oct 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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 3431 CO
Surgical Physician Assistant 363AS0400X PA.0003431 CO Primary

Addresses

Primary practice location

12605 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

PO Box 110429
Aurora, CO 80042-0429
Phone (303) 493-7000

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
I20120830000525 CO Practitioner - Physician Assistant 5991874471 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Denver Back Pain Specialists, LLCGroup PAC ID 8820246739, 8 clinicians

Practice addresses (Care Compare)

7730 E Belleview Ave
Suite A200
Greenwood Village, CO 80111-2617
Phone (303) 327-5511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3431COMDPhysician Assistant
PA.0003431COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Mid-Town Surgery Center LTD CurrentSince Jan 6, 2026 Accepting new patients
Dry Creek Surgery Center, LLC CurrentSince Jan 6, 2026 Accepting new patients
Regional Emergency Physicians PA Past Accepting new patients
Metro Denver Pain Management PLLC Past Accepting new patients

Locations

10700 E Geddes Ave
Ste 100
Englewood, CO 80112
Phone (303) 341-4730

7730 E Belleview Ave
Ste A200
Greenwood Village, CO 80111
Phone (303) 327-5511

7730 S Broadway
Littleton, CO 80122
Phone (303) 730-2376

Organizations & group practices 5

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1073666194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429",
            "telephone_number": "303-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12605 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "303-493-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEREMY",
        "middle_name": "BRADLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "3431",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0003431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.