Individual provider Active NPI

Jeffrey A Amundson, M.D.

  • Family Medicine Physician
  • Lakewood, CO
National Provider Identifier
1477524056
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35488 Issued in CO
Practice address
205 S Garrison St
Lakewood, CO 80226-2843
Phone
(303) 237-2779
Fax
(303) 237-4428
NPI assigned
Jan 31, 2006
Last updated
Dec 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35488 CO Primary

Addresses

Primary practice location

205 S Garrison St
Lakewood, CO 80226-2843

Mailing address

205 S Garrison St
Lakewood, CO 80226-2843
Phone (303) 237-2779

Other identifiers 3

IdentifierTypeStateIssuer
80226A003OtherTRICARE
01354885MedicaidCO
080124824OtherRR MEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100203000468 CO Practitioner - Family Practice 4284716036 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: jeffreyamundson@cpp.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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230508800000",
    "number": "1477524056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S GARRISON ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802262843",
            "telephone_number": "303-237-2779",
            "fax_number": "303-237-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S GARRISON ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802262843",
            "telephone_number": "303-237-2779",
            "fax_number": "303-237-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2008-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "35488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "80226A003",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01354885",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080124824",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.