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Individual provider Active NPI

Wesley P Jackson, MD

  • Orthopaedic Foot and Ankle Surgery Physician
  • Fort Collins, CO
National Provider Identifier
1194782995
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
DR.0044443 Issued in CO
Practice address
2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone
(970) 493-0112
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X DR.0044443 CO Primary

Addresses

Primary practice location

2500 E Prospect Rd
Fort Collins, CO 80525-9718

Mailing address

2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone (970) 493-0112

Other identifiers 3

IdentifierTypeStateIssuer
28656245MedicaidCO
P00377217OtherCORR MEDICARE
122675400MedicaidWY

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
I20060425000308 CO Practitioner - Orthopedic Surgery 5193735942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Northwestern University Feinberg Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone (970) 493-0112

2964 Ginnala Dr
Loveland, CO 80538-2701
Phone (970) 667-7755

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.72 of 100Reported as group
Quality
70.39
Promoting interoperability
71
Improvement activities
40
Cost
69.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0044443COMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic & Spine Center of the Rockies PC Orthopaedic Surgery CurrentSince Aug 15, 2006 Accepting new patients

Locations

2500 E Prospect Rd
Fort Collins, CO 80525
Phone (800) 722-7441

1926 61st Ave
Greeley, CO 80634
Phone (970) 573-3224

3470 E 15th St
Loveland, CO 80538
Phone (970) 663-3975

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 and National Provider Directory roles.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1194782995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E PROSPECT RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259718",
            "telephone_number": "970-493-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E PROSPECT RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259718",
            "telephone_number": "970-493-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "WESLEY",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "CO",
            "license": "DR.0044443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28656245",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00377217",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122675400",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.