NPIMap

Individual provider Active NPI

Jared G. Clay, M.D.

  • Surgery Physician
  • Usaf Academy, CO
National Provider Identifier
1295719268
Registry record updated Mar 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
DR-52995 Issued in CO
Practice address
4102 Pinion Dr
10 MDG
Usaf Academy, CO 80840-2502
Phone
(719) 333-5138
Fax
(719) 333-5836
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A94014 CA
Surgery Physician 208600000X DR-52995 CO Primary

Addresses

Primary practice location

4102 Pinion Dr
10 MDG
Usaf Academy, CO 80840-2502

Mailing address

4102 Pinion Dr
10 MDG
Usaf Academy, CO 80840-2502
Phone (719) 333-5138

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
I20140307000192 CO Practitioner - General Surgery 3476788225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Utah School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1400 E Boulder St
Suite 600 Uchmg General and Vascular Surgery
Colorado Springs, CO 80909-5533
Phone (719) 364-6487

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)15
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A94014CAMDSurgery Physician
DR-52995COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Surgery CurrentSince Feb 1, 2014 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 1, 2014 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1400 E Boulder St
Ste 600
Colorado Springs, CO 80909
Phone (719) 364-6487

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

4110 Briargate Pkwy
Ste 460
Colorado Springs, CO 80920
Phone (719) 364-6487

1400 E Boulder St
Ste 500
Colorado Springs, CO 80909
Phone (719) 364-6487

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

Organizations & group practices 2

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1295719268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "address_2": "10 MDG",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5138",
            "fax_number": "719-333-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "address_2": "10 MDG",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5138",
            "fax_number": "719-333-5836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY",
        "first_name": "JARED",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A94014",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "DR-52995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Usaf Academy, CO

Sources for this page

Verify at the official NPI Registry.