Individual provider Active NPI

Mark Brian Jones, PA-C

  • Surgical Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1144370933
Registry record updated Oct 17, 2016
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(4) exclusion effective Nov 20, 2023.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0000722 Issued in CO
Practice address
4105 Briargate Pkwy
Ste 300
Colorado Springs, CO 80920-3480
Phone
(719) 776-7846
Fax
(719) 776-3456
NPI assigned
Jan 12, 2007
Last updated
Oct 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA20750 CA
Surgical Physician Assistant 363AS0400X PA.0000722 CO Primary

Addresses

Primary practice location

4105 Briargate Pkwy
Ste 300
Colorado Springs, CO 80920-3480

Mailing address

4105 Briargate Pkwy
Ste 300
Colorado Springs, CO 80920-3480
Phone (719) 776-7846

Other identifiers 1

IdentifierTypeStateIssuer
1841240454MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20750CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Faculty Associates, Inc Past Accepting new patients

Organizations & group practices 1

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1144370933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 BRIARGATE PKWY",
            "address_2": "STE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203480",
            "telephone_number": "719-776-7846",
            "fax_number": "719-776-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 BRIARGATE PKWY",
            "address_2": "STE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203480",
            "telephone_number": "719-776-7846",
            "fax_number": "719-776-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MARK",
        "middle_name": "BRIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA20750",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0000722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841240454",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.