NPIMap

Individual provider Active NPI

Jordan Nathaniel Gallegos, MD

  • Epilepsy Physician
  • Aurora, CO
National Provider Identifier
1174029839
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Epilepsy PhysicianTaxonomy code 2084E0001X
License
DR.0069374 Issued in CO
Practice address
1635 Aurora CT
Aurora, CO 80045-2541
Phone
(720) 848-0000
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X DR.0069374 CO
Epilepsy Physician 2084E0001X DR.0069374 CO Primary

Addresses

Primary practice location

1635 Aurora CT
Aurora, CO 80045-2541

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

13001 E. 17th Place
Aurora, CO 80045-2581
Phone (303) 724-1792

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
I20230907002619 CO Practitioner - EpileptologistsPractitioner - Neurology 4284980038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EpileptologistsAlso: Neurology
Education
Emory University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

1635 Aurora CT
Aurora, CO 80045-2541
Phone (720) 848-0000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0069374COMDEpilepsy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated CurrentSince Sep 1, 2023 Accepting new patients
University Physicians Incorporated Neurology Current Accepting new patients
University Physicians, Incorporated CurrentSince Sep 1, 2023 Accepting new patients
University of Colorado Hospital Authority Past Accepting new patients

Locations

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

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

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

1635 Aurora Ct
Fl 5
Aurora, CO 80045
Phone (720) 848-2300

1635 Aurora Ct
Aurora, CO 80045
Phone (720) 848-1060

Dept 1061
Denver, CO 80256

Organizations & group practices 4

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.

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1174029839",
    "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": "1635 AURORA CT",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452541",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13001 E. 17th Place",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452581",
            "country_code": "US",
            "telephone_number": "303-724-1792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "JORDAN",
        "middle_name": "NATHANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "DR.0069374",
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "CO",
            "license": "DR.0069374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.