Individual provider Active NPI

Jered Nystrom, MD

  • Diagnostic Radiology Physician
  • Aurora, CO
National Provider Identifier
1366903726
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
DR.0073070 Issued in CO
Practice address
12605 E 16TH Ave
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Mar 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X DR.0073070 CO
Pediatric Radiology Physician 2085P0229X DR.0073070 CO
Vascular & Interventional Radiology Physician 2085R0204X DR.0073070 CO
Diagnostic Radiology Physician 2085R0202X DR.0073070 CO Primary

Addresses

Primary practice location

12605 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

12401 E 17th Ave
Aurora, CO 80045-2548
Phone (720) 848-0000

Other practice location 2

100 Cook St Ste 100
Denver, CO 80206-5327
Phone (720) 516-9420

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
I20240628003745 CO Practitioner - Diagnostic RadiologyPractitioner - Interventional RadiologyPractitioner - Nuclear MedicinePractitioner - Pediatric Medicine 1355766379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology, Nuclear Medicine, Pediatric Medicine
Education
University of Wisconsin School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

777 Bannock St
Denver, CO 80204-4507
Phone (303) 436-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Uchealth Imaging Services, LLC Diagnostic Radiology CurrentSince Sep 26, 2024 Accepting new patients
Uchealth Imaging Services, LLC Diagnostic Radiology CurrentSince Sep 26, 2024 Accepting new patients
University Physicians Incorporated Current Accepting new patients
Denver Health and Hospital Authority CurrentSince Jun 13, 2025 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jun 13, 2025 Accepting new patients

Locations

12401 E 17th Ave
Aurora, CO 80045
Phone (720) 777-8613

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

875 W 136th Ave
Ste 100
Broomfield, CO 80023
Phone (303) 457-7700

777 Bannock St
Denver, CO 80204

Dept 1061
Denver, CO 80256

100 Cook St
Ste 410
Denver, CO 80206
Phone (720) 516-9420

5589 Argonne St
Denver, CO 80249
Phone (303) 371-0330

100 Cook St
Ste 404
Denver, CO 80206
Phone (720) 516-9200

100 Cook St
Ste 100
Denver, CO 80206
Phone (720) 516-9420

100 Cook St
Ste 212
Denver, CO 80206
Phone (720) 516-9200

175 Inverness Dr W
Ste 150
Englewood, CO 80112
Phone (720) 516-9800

1500 Park Central Dr
Ste 401
Highlands Ranch, CO 80129
Phone (720) 516-4085

Interoperability endpoints

  • Direct secure messaging: jnystrom230271@direct.dhha.org

Organizations & group practices 5

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 3

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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1366903726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12605 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12401 E 17th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452548",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Cook St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802065327",
            "country_code": "US",
            "telephone_number": "720-516-9420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYSTROM",
        "first_name": "JERED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "CO",
            "license": "DR.0073070",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "CO",
            "license": "DR.0073070",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CO",
            "license": "DR.0073070",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0073070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.