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Individual provider Active NPI

Jill R Hanson, MD

  • Allergy & Immunology Physician
  • Colorado Springs, CO
National Provider Identifier
1366763807
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
DR.0067275 Issued in CO
Practice address
6031 E Woodmen Rd Ste 300
Colorado Springs, CO 80923-2624
Phone
(719) 867-7800
Fax
(719) 867-7899
NPI assigned
Jun 18, 2010
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X DR.0067275 CO Primary

Addresses

Primary practice location

6031 E Woodmen Rd Ste 300
Colorado Springs, CO 80923-2624

Mailing address

6031 E Woodmen Rd Ste 300
Colorado Springs, CO 80923-2624
Phone (719) 867-7814

Other practice location 1

3030 N Circle Dr Ste 300
Colorado Springs, CO 80909-1180
Phone (719) 867-7800

Other names 1

  • Jill R Russell Former name

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
I20211019003045 CO Practitioner - Allergy/Immunology 9436451762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Nebraska College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Otolaryngology Associates, LLCGroup PAC ID 1557253705, 21 clinicians

Practice addresses (Care Compare)

3030 N Circle Dr
Suite 300
Colorado Springs, CO 80909-1180
Phone (719) 867-7800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.99 of 100Reported as group
Quality
80.65
Promoting interoperability
100
Improvement activities
40
Cost
62.66

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0067275COMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Otolaryngology Associates, LLC CurrentSince Aug 24, 2021 Accepting new patients

Locations

3030 N Circle Dr
Ste 300
Colorado Springs, CO 80909
Phone (719) 373-1289

6031 E Woodmen Rd
Ste 300
Colorado Springs, CO 80923
Phone (719) 484-8626

3595 E Spaulding Ave
Ste B
Pueblo, CO 81008
Phone (719) 867-7800

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1366763807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6031 E WOODMEN RD STE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809232624",
            "telephone_number": "719-867-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6031 E WOODMEN RD STE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809232624",
            "telephone_number": "719-867-7800",
            "fax_number": "719-867-7899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 N Circle Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809091180",
            "country_code": "US",
            "telephone_number": "719-867-7800",
            "fax_number": "719-867-7899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "JILL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CO",
            "license": "DR.0067275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "RUSSELL",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.