Individual provider Active NPI

Jay Jiayi Shi, MD

  • Internal Medicine Physician
  • Denver, CO
National Provider Identifier
1265963524
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0064481 Issued in CO
Practice address
1400 Jackson St
Building T Suite 550
Denver, CO 80206
Phone
(303) 812-3800
Fax
(303) 812-4172
NPI assigned
Mar 27, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0064481 CO Primary

Addresses

Primary practice location

1400 Jackson St
Building T Suite 550
Denver, CO 80206

Mailing address

1400 Jackson Street
Building T Suite 550
Denver, CO 80206
Phone (303) 812-3800

Other names 1

  • Jiayi Shi Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200716001528 CO Practitioner - Internal Medicine 4082963566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

1400 Jackson St
BLDG T
Denver, CO 80206-2761
Phone (303) 812-3800

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R4585KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Internal Medicine Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jul 1, 2020 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jul 1, 2020 Accepting new patients
Intermountain Medical Group Denver, LLC PastSince Oct 17, 2021 Accepting new patients

Locations

500 Eldorado Blvd
Ste 6300
Broomfield, CO 80021
Phone (303) 272-0803

1400 Jackson St
Ste 550
Denver, CO 80206
Phone (303) 318-3800

1400 Jackson St
Bldg T
Denver, CO 80206
Phone (303) 812-3800

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 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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1265963524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 JACKSON STREET",
            "address_2": "BUILDING T SUITE 550",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80206",
            "telephone_number": "303-812-3800",
            "fax_number": "303-812-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 JACKSON ST",
            "address_2": "BUILDING T SUITE 550",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80206",
            "telephone_number": "303-812-3800",
            "fax_number": "303-812-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHI",
        "first_name": "JAY",
        "middle_name": "JIAYI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0064481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIAYI",
            "last_name": "SHI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.