NPIMap

Individual provider Active NPI

Marissa Daniels Jamieson, MD

  • Orthopaedic Foot and Ankle Surgery Physician
  • Denver, CO
National Provider Identifier
1265878599
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
DR.0061575 Issued in CO
Practice address
100 Cook Street
Suite 406
Denver, CO 80206
Phone
(720) 516-9417
Fax
(720) 516-9445
NPI assigned
May 14, 2013
Last updated
Aug 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 35134186 OH
Orthopaedic Surgery Physician 207X00000X DR.0061575 CO
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X DR.0061575 CO Primary

Addresses

Primary practice location

100 Cook Street
Suite 406
Denver, CO 80206

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

543 Taylor Ave
Columbus, OH 43203
Phone (614) 293-2663

Other identifiers 1

IdentifierTypeStateIssuer
0303783MedicaidOH

Other names 1

  • Marissa Cindra Daniels Former name

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
I20190724003028 CO Practitioner - Orthopedic Surgery 2365679610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Texas Southwestern Medical School at Dallas, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

100 Cook St
Denver, CO 80206-5340

400 Indiana St
Golden, CO 80401-5033
Phone (720) 452-1267

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35134186OHMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Orthopaedic Surgery CurrentSince Aug 1, 2020 Accepting new patients
Poudre Valley Medical Group, LLC Orthopaedic Surgery Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 8, 2020 Accepting new patients

Locations

100 Cook St
Ste 406
Denver, CO 80206
Phone (720) 516-9417

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 3

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1265878599",
    "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": "100 COOK STREET",
            "address_2": "SUITE 406",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80206",
            "telephone_number": "720-516-9417",
            "fax_number": "720-516-9445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "543 Taylor Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "43203",
            "country_code": "US",
            "telephone_number": "614-293-2663",
            "fax_number": "614-293-2053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMIESON",
        "first_name": "MARISSA",
        "middle_name": "DANIELS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35134186",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "DR.0061575",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "CO",
            "license": "DR.0061575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0303783",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "DANIELS",
            "middle_name": "CINDRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.