NPIMap

Individual provider Active NPI

Jason William Ptak, PA-C

  • Medical Physician Assistant
  • Hartford, CT
National Provider Identifier
1437566338
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
005617 Issued in CT
Practice address
500 Albany Ave
Hartford, CT 06120-2508
Phone
(860) 249-9625
NPI assigned
Jul 13, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X PA-1993 ID
Medical Physician Assistant 363AM0700X 005617 CT Primary

Addresses

Primary practice location

500 Albany Ave
Hartford, CT 06120-2508

Mailing address

500 Albany Ave
Hartford, CT 06120-2508
Phone (860) 249-9625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220623000411 CT Practitioner - Physician Assistant 3072866755 Reassigns benefits to 2 organizations
I20250718004006 CO Practitioner - Physician Assistant 3072866755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2767 Janitell Rd
Colorado Springs, CO 80906-4102
Phone (719) 365-2888

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005617CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care P.a. CurrentSince Jul 9, 2025 Accepting new patients
American Current Care PA CurrentSince Jul 9, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Mar 1, 2026 Accepting new patients
Community Health Services, Inc. CurrentSince Feb 27, 2023 Accepting new patients
WRK Ventures, LLC Past Accepting new patients

Locations

2767 Janitell Rd
Colorado Springs, CO 80906
Phone (719) 365-2888

13445 Voyager Pkwy
Colorado Springs, CO 80921
Phone (719) 219-0333

4323 Integrity Center Pt
Colorado Springs, CO 80917
Phone (719) 591-2558

1730 Blake St
Ste 100
Denver, CO 80202
Phone (303) 296-2273

11605 Meridian Market Vw
Ste 184
Peyton, CO 80831
Phone (719) 364-9555

500 Albany Ave
Hartford, CT 06120
Phone (860) 249-9625

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Interoperability endpoints

  • Direct secure messaging: jptak391286@direct.multicare.org

Organizations & group practices 8

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 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": "1405209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1437566338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ALBANY AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061202508",
            "telephone_number": "860-249-9625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALBANY AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061202508",
            "telephone_number": "860-249-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PTAK",
        "first_name": "JASON",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-1993",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "005617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.