Jacqueline Ann Duba, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA.0000930 Issued in CO

Practice address

360 Peak One Dr Ste 100
Frisco, CO 80443-5948

Phone

(970) 668-4040

NPI assigned

Jul 7, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

George Washington University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Community Care Clinic IncGroup PAC ID 8022284074, shared by 8 NPIs, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jduba770537@direct.ochin.org

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.

• Southeast Alaska Regional Health Consortium

  • Clinic/Center
  • Thorne Bay, AK
  • NPI 1376758037

  TX

  Medicare reassignment
• Southeast Alaska Regional Health Consortium

  • Clinic/Center
  • Juneau, AK
  • NPI 1427941343
  NPD
• Southeast Alaska Regional Health Constortium

  • Clinic/Center
  • Sitka, AK
  • NPI 1538521026
  NPD

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1396743050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 525",
            "city": "LEADVILLE",
            "state": "CO",
            "postal_code": "804610525",
            "telephone_number": "719-838-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 PEAK ONE DR STE 100",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "804435948",
            "telephone_number": "970-668-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBA",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0000930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40820025",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Dion, MA, LPC
• Kathy Ditlow, CRNFA
• Casey Donohoe, LSW
• Erik R Dorf, MD
• Shannon Downen
• Alan M Dulit, M.D.
• Emily Ann Duncanson, DPT
• Eagle-Summit Foot & Ankle, P.C.
• Eagle-Summit Foot & Ankle, P.C.
• Eagle-Summit Speech-Language Services, Inc.

• Medical Physician Assistant in Frisco, CO
• Providers in Frisco, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.