Individual provider Active NPI

Jamie M. Mendoza, OTR/L

  • Hand Occupational Therapist
  • Colorado Springs, CO
National Provider Identifier
1336198738
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT5817 Issued in CA
Practice address
4110 Briargate Pkwy Ste 300
Colorado Springs, CO 80920-7837
Phone
(719) 632-7669
Fax
(719) 632-0088
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X OT5817 CA Primary

Addresses

Primary practice location

4110 Briargate Pkwy Ste 300
Colorado Springs, CO 80920-7837

Mailing address

1120 Trek Trail HTS Apt 208
Colorado Springs, CO 80921-4515
Phone (858) 922-5402

Other practice location 1

1259 Lake Plaza Dr Ste 100
Colorado Springs, CO 80906-3542
Phone (719) 632-7669

Other names 1

  • Jamie M. Leeser Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160303000758 CO Practitioner - Occupational Therapist in Private Practice 5496852048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1259 Lake Plaza Dr
Suite 100
Colorado Springs, CO 80906-3542
Phone (719) 632-7669

4110 Briargate Pkwy
Suite 300
Colorado Springs, CO 80920-7837
Phone (719) 632-7669

Merit-based Incentive Payment System (MIPS)

Final score
83.06 of 100Reported as group
Quality
70.6
Promoting interoperability
99
Improvement activities
40
Cost
73.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5817CAMDAcupuncturist
OT5817CAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Springs Orthopaedic Group CurrentSince Dec 20, 2015 Accepting new patients
Colorado Springs Orthopaedic Group Current Accepting new patients
Colorado Springs Orthopaedic Group CurrentSince Dec 20, 2015 Accepting new patients
Barbara Jean Boutelle Carlsbad Physical Therapy Occupational Therapist Past Accepting new patients
Barbara Jean Boutelle Carlsbad Physical Therapy Past Accepting new patients
Bakersfield Memorial Hospital PastSince Oct 27, 2020 Accepting new patients

Locations

1259 Lake Plaza Dr
Ste 100
Colorado Springs, CO 80906
Phone (719) 867-7335

4110 Briargate Pkwy
Ste 300
Colorado Springs, CO 80920
Phone (719) 867-7329

1655 Quail Lake Loop
Colorado Springs, CO 80906
Phone (719) 417-4931

Organizations & group practices 6

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1336198738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 TREK TRAIL HTS APT 208",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809214515",
            "telephone_number": "858-922-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 BRIARGATE PKWY STE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207837",
            "telephone_number": "719-632-7669",
            "fax_number": "719-632-0088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1259 Lake Plaza Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809063542",
            "country_code": "US",
            "telephone_number": "719-632-7669",
            "fax_number": "719-632-0088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "JAMIE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "OT5817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "LEESER",
            "middle_name": "M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.