Individual provider Active NPI

Jenna Leigh Lichtenberg

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1467114173
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0008596 Issued in CO
Practice address
1411 S Potomac St Ste 210
Aurora, CO 80012-4538
Phone
(303) 695-6106
NPI assigned
Oct 10, 2021
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0008596 CO Primary

Addresses

Primary practice location

1411 S Potomac St Ste 210
Aurora, CO 80012-4538

Mailing address

10200 Grand Central Ave Ste 220
Owings Mills, MD 21117-4366

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240920002822 CO Practitioner - Physician Assistant 4587049739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

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
PA0008596COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Urology, PLLC CurrentSince Sep 1, 2024 Accepting new patients
Advanced Urology, PLLC CurrentSince Sep 1, 2024 Accepting new patients
Healthone Clinic Services - Primary Care LLC CurrentSince Dec 8, 2025 Accepting new patients
Foothills Urology, PC Current Accepting new patients
Advanced Urology, PLLC Current Accepting new patients
Advanced Ambulatory Surgery Center LLC PastSince Jun 5, 2022 Accepting new patients
Advanced Urology, PLLC Past Accepting new patients

Locations

1411 S Potomac St
Aurora, CO 80012
Phone (303) 751-0300

1411 S Potomac St
Ste 210
Denver, CO 80012
Phone (303) 750-0883

4500 E 9th Ave
Ste 470
Denver, CO 80220
Phone (303) 320-8499

4809 Argonne St
Denver, CO 80249
Phone (303) 563-2784

501 E Hampden Ave
Englewood, CO 80113
Phone (303) 788-5300

32135 Castle Ct
Ste 101
Evergreen, CO 80439
Phone (303) 679-8500

255 S Routt St
Ste 420
Lakewood, CO 80228
Phone (303) 985-2550

10200 Grand Central Ave
Ste 220
Owings Mills, MD 21117

25 Crossroads Dr
Ste 306
Owings Mills, MD 21117
Phone (443) 231-1681

Interoperability endpoints

  • Direct secure messaging: jennalichtenberg@fu.allscriptsdirect.net

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1633824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1467114173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 GRAND CENTRAL AVE STE 220",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 S POTOMAC ST STE 210",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124538",
            "telephone_number": "303-695-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENBERG",
        "first_name": "JENNA",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-10",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0008596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.