Individual provider Active NPI

Jessica Ballou

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1124632815
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0006339 Issued in CO
Practice address
13001 E 17TH PL RM E7019
Aurora, CO 80045-2570
Phone
(303) 724-7963
NPI assigned
Sep 1, 2020
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0006339 CO Primary

Addresses

Primary practice location

13001 E 17TH PL RM E7019
Aurora, CO 80045-2570

Mailing address

9842 E Florida PL
Aurora, CO 80247-7343
Phone (970) 376-8613

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
I20210512001962 CO Practitioner - Physician Assistant 7315356839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Colorado School of Medicine, Aurora, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steadman Clinic Professional LLCGroup PAC ID 7719876226, 77 clinicians

Practice addresses (Care Compare)

181 W Meadow Dr
Suite 400
Vail, CO 81657-5058
Phone (970) 476-1100

322 Beard Creek Rd
Edwards, CO 81632-6426
Phone (970) 476-1100

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0006339COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Steadman Clinic Professional LLC CurrentSince Jun 20, 2022 Accepting new patients
Steadman Clinic Professional LLC CurrentSince Jun 20, 2022 Accepting new patients

Locations

401 Castle Creek Rd
Ste 2100
Aspen, CO 81611
Phone (970) 544-1289

200 Robinson St
Ste C300
Basalt, CO 81621

322 Beard Creek Rd
Edwards, CO 81632
Phone (970) 569-7429

181 W Meadow Dr
Ste 400
Vail, CO 81657
Phone (970) 680-0795

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": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1124632815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9842 E FLORIDA PL",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "802477343",
            "telephone_number": "970-376-8613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13001 E 17TH PL RM E7019",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452570",
            "telephone_number": "303-724-7963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLOU",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.