NPIMap

Individual provider Active NPI

Janelle R Stewart, PA-C

  • Physician Assistant
  • Durango, CO
National Provider Identifier
1427010842
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0003765 Issued in CO
Practice address
523 S Camino del Rio, Ste B
Durango, CO 81303
Phone
(970) 247-1970
Fax
(970) 247-1970
NPI assigned
Apr 3, 2006
Last updated
Nov 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8433186-1206 UT
Physician Assistant 363A00000X 3765 CO
Physician Assistant 363A00000X PA.0003765 CO Primary
Physical Therapist 225100000X 8695 CO

Addresses

Primary practice location

523 S Camino del Rio, Ste B
Durango, CO 81303

Mailing address

523 S Camino del Rio, Ste B
Durango, CO 81303
Phone (970) 247-1970

Other identifiers 2

IdentifierTypeStateIssuer
9000128352MedicaidCO
18757049MedicaidCO

Other names 1

  • Janelle R Stewart Professional 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
I20140220000949 CO Practitioner - Physician Assistant 0547219024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Durango Dermatology and Dermatologic Surgery LLCGroup PAC ID 1153375902, 9 clinicians

Practice addresses (Care Compare)

523 S Camino del Rio
Suite B
Durango, CO 81303-6853
Phone (970) 247-1970

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8695COMDProsthodontist
3765COMDPhysician Assistant
PA.0003765COMDPhysician Assistant
8433186-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Durango Sports Club, Inc. Physical Therapist PastSince Jan 4, 1993 Accepting new patients
Durango Dermatology and Dermatologic Surgery LLC PastSince Nov 13, 2022 Accepting new patients
Utah Navajo Health System, Incorporated Past Accepting new patients
Utah Navajo Health System, Incorporated Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jastewart@durango.emadirect.md

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1427010842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 S CAMINO DEL RIO, STE B",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "81303",
            "telephone_number": "970-247-1970",
            "fax_number": "970-259-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 S CAMINO DEL RIO, STE B",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "81303",
            "telephone_number": "970-247-1970",
            "fax_number": "970-247-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JANELLE",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8433186-1206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "3765",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0003765",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "8695",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000128352",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18757049",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANELLE",
            "last_name": "STEWART",
            "middle_name": "R",
            "credential": "PA-C, PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.