Amar Chand Jetty, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

DR45869 Issued in CO

Practice address

1100 Carson Ave
La Junta, CO 81050-2751

Phone

(719) 383-5189

Fax

(719) 383-6566

NPI assigned

Oct 4, 2007

Last updated

Apr 18, 2008By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health and Human Services CommissionGroup PAC ID 2163795824, 138 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Health and Human Services Commission

  dba Rio Grande State Center

  • Clinical Neuropsychologist
  • Harlingen, TX
  • NPI 1356414692
  Medicare reassignment Care Compare group NPD
• Poppy Drive Inpatient Services PLLC

  • Emergency Medicine Physician
  • Sunnyvale, TX
  • NPI 1417379058
  Medicare reassignment NPD
• Health and Human Services Commission

  dba Big Spring State Hospital

  • Psychiatric Hospital
  • Big Spring, TX
  • NPI 1881600682
  NPD

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1124216080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CARSON AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810502751",
            "telephone_number": "719-383-5189",
            "fax_number": "719-383-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CARSON AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810502751",
            "telephone_number": "719-383-5189",
            "fax_number": "719-383-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETTY",
        "first_name": "AMAR",
        "middle_name": "CHAND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-04",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "DR45869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DR-45869",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00452978",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13352857",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inspiration Field
• Inspiration Field
• Inspiration Field
• Inspiration Field (Global Therapy & Services)
• Thomas Miles Jackson, MD
• CHI-Ann Dae Johnson, ACNPC-AG
• Elisabeth Dawn Johnson, RN
• Patricia K Johnson, F.N.P.
• Joseph L Collins MD PC
• Josh Brothers Dental PLLC

• Specialist in La Junta, CO
• Providers in La Junta, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.