NPIMap

Individual provider Active NPI

John D Prince, PA

  • Surgical Physician Assistant
  • Durango, CO
National Provider Identifier
1386895407
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0007004 Issued in CO
Practice address
1 Mercado St
Ste 200
Durango, CO 81301-7308
Phone
(970) 382-9500
NPI assigned
Oct 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA.0007004 CO Primary

Addresses

Primary practice location

1 Mercado St
Ste 200
Durango, CO 81301-7308

Mailing address

1 Mercado St
Ste 200
Durango, CO 81301-7308
Phone (970) 382-9500

Other practice location 1

314 S 6th St
Montrose, CO 81401-5719
Phone (970) 982-9500

Other identifiers 1

IdentifierTypeStateIssuer
PA9104758OtherFLLICENSE

Other names 1

  • John Daniel Prince Other 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
I20211105000522 CO Practitioner - Physician Assistant 3678621943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spine Colorado PCGroup PAC ID 0941199830, 9 clinicians

Practice addresses (Care Compare)

1 Mercado St
Durango, CO 81301-7306

1 Mercado St
Suite 200
Durango, CO 81301-7308
Phone (970) 382-9500

Hospital & facility affiliations

  • Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013
  • Southwest Memorial Hospital Hospital, Cortez, CO, CCN 061327
  • Pagosa Springs Medical Center Hospital, Pagosa Springs, CO, CCN 061328
  • Animas Surgical Hospital, LLC Hospital, Durango, CO, CCN 060117
  • Rio Grande Hospital Hospital, Del Norte, CO, CCN 061301

Merit-based Incentive Payment System (MIPS)

Final score
81.35 of 100Reported as group
Quality
65.9
Promoting interoperability
100
Improvement activities
40
Cost
71.92

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0007004COMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: john.prince.1@16938.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1386895407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "STE 200",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017308",
            "telephone_number": "970-382-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "STE 200",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017308",
            "telephone_number": "970-382-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "314 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Montrose",
            "state": "CO",
            "postal_code": "814015719",
            "country_code": "US",
            "telephone_number": "970-982-9500",
            "fax_number": "970-375-0007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-07",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0007004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA9104758",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "PRINCE",
            "middle_name": "DANIEL",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.