NPIMap

Individual provider Active NPI

Jamie Sullivan, PA

  • Surgical Physician Assistant
  • Englewood, CO
National Provider Identifier
1104299759
Registry record updated Sep 9, 2024
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Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5800 Issued in CO
Practice address
175 Inverness Dr W
Englewood, CO 80112-5065
Phone
(720) 848-0000
NPI assigned
Nov 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-06053 NC
Medical Physician Assistant 363AM0700X 5800 CO
Surgical Physician Assistant 363AS0400X 5800 CO Primary

Addresses

Primary practice location

175 Inverness Dr W
Englewood, CO 80112-5065

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

12605 E 16th Ave
Aurora, CO 80045-2545
Phone (720) 848-0000

Other names 1

  • Jamie Weiss Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151229002765 NC Practitioner - Physician Assistant 9537461033
I20191105000916 CO Practitioner - Physician Assistant 9537461033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

175 Inverness Dr West
200 Cu Medicine Steadman Hawkins Ortho and SP
Englewood, CO 80112-5065
Phone (303) 694-3333

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5800COMDChiropractor
0010-06053NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince Oct 7, 2019 Accepting new patients
University Physicians, Incorporated Sports Medicine CurrentSince Oct 7, 2019 Accepting new patients

Locations

1635 Aurora Ct
Fl 4
Aurora, CO 80045
Phone (720) 848-2000

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

175 Inverness Dr W
Ste 200
Englewood, CO 80112
Phone (303) 469-3182

1500 Park Central Dr
Littleton, CO 80129
Phone (720) 516-1000

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.

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": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1104299759",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 INVERNESS DR W",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801125065",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12605 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452545",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JAMIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06053",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "5800",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "5800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "WEISS",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.