Active NPI
Jennifer Bocker
- Surgery Physician
- Wheat Ridge, CO
National Provider Identifier
1467475152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 51097
- Practice address
- 3455 Lutheran Pkwy
Suite 290
Wheat Ridge, CO 80033-6028 - Phone
- (303) 940-8200
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 236364-1 | NY | |
| Surgery Physician | 208600000X | 51097 | CO | Primary |
Addresses
Primary practice location
3455 Lutheran Pkwy
Suite 290
Wheat Ridge, CO 80033-6028
Mailing address
3455 Lutheran Pkwy
Suite 290
Wheat Ridge, CO 80033-6028
Phone (303) 940-8200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02689292 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 236364-1 | NY | MD | Emergency Medicine Physician |
| 51097 | CO | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coney Island Medical Practice Plan, P.C. | Past | Accepting new patients | |
| University Group Medical Associates, P.C | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Physician
- Brooklyn, NY
- NPI 1386951762
-
- Diagnostic Radiology Physician
- Brooklyn, NY
- NPI 1285683102
Emergency Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422921600000",
"number": "1467475152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3455 LUTHERAN PKWY",
"address_2": "SUITE 290",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800336028",
"telephone_number": "303-940-8200",
"fax_number": "303-940-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3455 LUTHERAN PKWY",
"address_2": "SUITE 290",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800336028",
"telephone_number": "303-940-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOCKER",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2015-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "236364-1",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CO",
"license": "51097",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02689292",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wheat Ridge, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.