NPIMap

Individual provider Active NPI

Jack Johnson, MD

  • Anesthesiology Physician
  • Denver, CO
National Provider Identifier
1356316996
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
37891 Issued in CO
Practice address
455 Sherman St
Ste 510
Denver, CO 80203-4400
Phone
(303) 377-6825
Fax
(303) 780-0787
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 37891 CO Primary

Addresses

Primary practice location

455 Sherman St
Ste 510
Denver, CO 80203-4400

Mailing address

455 Sherman St
Ste 510
Denver, CO 80203-4400
Phone (303) 377-6825

Other identifiers 1

IdentifierTypeStateIssuer
51687275MedicaidCO

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
I20101202000705 CO Practitioner - Anesthesiology 8325107147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
US Anesthesia Partners of Colorado IncGroup PAC ID 6002072055, 472 clinicians

Practice addresses (Care Compare)

10101 Ridgegate Pkwy
Lone Tree, CO 80124-5522
Phone (303) 438-3999

1501 S Potomac St
Aurora, CO 80012-5411

2350 Meadows Blvd
Castle Rock, CO 80109-8405
Phone (303) 438-3999

9395 Crown Crest Blvd
Parker, CO 80138-8573
Phone (303) 438-3999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
85
Improvement activities
40
Cost
76.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37891COMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
US Anesthesia Partners of Colorado Inc. Anesthesiology CurrentSince Aug 1, 2012 Accepting new patients
US Anesthesia Partners of Kansas PA Anesthesiology PastSince Jun 16, 2024 Accepting new patients

Locations

455 N Sherman St
Ste 510
Denver, CO 80203
Phone (303) 336-8304

8000 E Maplewood Ave
Ste 120
Greenwood Village, CO 80111

10101 Ridgegate Pkwy
Lone Tree, CO 80124
Phone (720) 225-1000

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1356316996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 SHERMAN ST",
            "address_2": "STE 510",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802034400",
            "telephone_number": "303-377-6825",
            "fax_number": "303-780-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 SHERMAN ST",
            "address_2": "STE 510",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802034400",
            "telephone_number": "303-377-6825",
            "fax_number": "303-780-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "37891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51687275",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.