Individual provider Active NPI

Jenna Pappas, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1265946644
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0005124 Issued in CO
Practice address
1795 Jet Wing Dr
Colorado Springs, CO 80916-2332
Phone
(719) 572-6100
Fax
(719) 572-6186
NPI assigned
Nov 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0005124 CO Primary

Addresses

Primary practice location

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332

Mailing address

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332
Phone (719) 572-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180122000311 CO Practitioner - Physician Assistant 5698034601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Diversus Health IncGroup PAC ID 7719879204, 49 clinicians

Practice addresses (Care Compare)

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332
Phone (719) 572-6100

6208 Lehman Dr
Colorado Springs, CO 80918-8408
Phone (719) 572-6100

875 W Moreno Ave
Colorado Springs, CO 80905-1731
Phone (719) 572-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0005124COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Diversus Health Inc CurrentSince Dec 17, 2017 Accepting new patients
Diversus Health Inc CurrentSince Dec 17, 2017 Accepting new patients

Locations

460 County Road 43
Ste 7
Bailey, CO 80421
Phone (303) 838-5013

328 10th St
Calhan, CO 80808

115 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6340

413 Security Blvd
Colorado Springs, CO 80911

220 Ruskin Dr
Colorado Springs, CO 80910
Phone (719) 572-6150

179 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6300

1795 Jet Wing Dr
Colorado Springs, CO 80916
Phone (719) 572-6111

875 W Moreno Ave
Colorado Springs, CO 80905
Phone (719) 572-6200

6208 Lehman Dr
Colorado Springs, CO 80918
Phone (719) 572-6133

18401 Highway 24
Ste 119
Woodland Park, CO 80863

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1265946644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 JET WING DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162332",
            "telephone_number": "719-572-6100",
            "fax_number": "719-572-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 JET WING DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162332",
            "telephone_number": "719-572-6100",
            "fax_number": "719-572-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPAS",
        "first_name": "JENNA",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.