Jason Tyler Hendricks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0009729 Issued in CO

Practice address

175 S Union Blvd Ste 125
Colorado Springs, CO 80910-3147

Phone

(719) 365-1950

Fax

(719) 365-1951

NPI assigned

Mar 3, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2026

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  NPD (past)
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD (past)

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

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1093513582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 SWIFT CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809104312",
            "telephone_number": "717-606-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S UNION BLVD STE 125",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103147",
            "telephone_number": "719-365-1950",
            "fax_number": "719-365-1951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Cochrane Cir Unit Meddac",
            "address_purpose": "LOCATION",
            "city": "Ft Carson",
            "state": "CO",
            "postal_code": "809134604",
            "country_code": "US",
            "telephone_number": "719-526-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "JASON",
        "middle_name": "TYLER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-03",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0009729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Hendrick, MS, CNS, LDN
• Jeffrey Hendrick
• Jevon Hendrick
• Joanne Hendrick, OD
• Arvin Demetrius Hendricks
• Jerry Allen Hendricks, O.D.
• Laura Ef Hendricks, NP
• Rush Davis Hendricks, DPT
• Austin Hendrickson, LPC
• Jada Hendrickson

• Physician Assistant in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.