NPIMap

Individual provider Active NPI

Jonathan P Degner, PA-C

  • Surgical Physician Assistant
  • Lakewood, CO
National Provider Identifier
1154604452
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0004374 Issued in CO
Practice address
11700W 2ND PL 280
Lakewood, CO 80228-1717
Phone
(720) 321-8680
NPI assigned
Sep 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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 PA001288 ME
Surgical Physician Assistant 363AS0400X 0004374 CO Primary

Addresses

Primary practice location

11700W 2ND PL 280
Lakewood, CO 80228-1717

Mailing address

11700W 2ND PL 280
Lakewood, CO 80228-1717
Phone (720) 321-8680

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151029000313 CO Practitioner - Physician Assistant 3476710856 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

11600 W 2ND PL
Lakewood, CO 80228-1527

11650 W 2ND PL
Lakewood, CO 80228-1527

11700 W 2ND PL
Suite 280
Lakewood, CO 80228-1717
Phone (720) 321-8680

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0004374COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Oct 5, 2015 Accepting new patients
Valley View Hospital Association CurrentSince May 15, 2019 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Oct 5, 2015 Accepting new patients
Valley View Hospital Association CurrentSince May 15, 2019 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033

11700 W 2nd Pl
Ste 280
Lakewood, CO 80228
Phone (720) 321-8680

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 7

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 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1154604452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700W 2ND PL 280",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281717",
            "telephone_number": "720-321-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700W 2ND PL 280",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281717",
            "telephone_number": "720-321-8680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGNER",
        "first_name": "JONATHAN",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-22",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA001288",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "0004374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.