Active NPI
Jay C. Neubauer, MD, MPH
- Aerospace Medicine Physician
- US Air Force, CO
National Provider Identifier
1477545887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Aerospace Medicine Physician
- License
- DR0054745
- Practice address
- 2355 Faculty Dr
US Air Force, CO 80840-1805 - Phone
- (719) 333-0533
- NPI assigned
- Aug 22, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Aerospace Medicine Physician | 2083A0100X | 0101038954 | VA | |
| Aerospace Medicine Physician | 2083A0100X | DR0054745 | CO | Primary |
Addresses
Primary practice location
2355 Faculty Dr
US Air Force, CO 80840-1805
Mailing address
10 MDG
4102 Pinion Dr.
Usaf Academy, CO 80840
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0054745 | Other | CO | MEDICAL LICENSE |
| 0101038954 | Other | VA | MEDICAL LICENSE |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR0054745 | CO | MD | Aerospace Medicine Physician |
| 0101038954 | VA | MD | Aerospace Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734912000000",
"number": "1477545887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 MDG",
"address_2": "4102 PINION DR.",
"city": "USAF ACADEMY",
"state": "CO",
"postal_code": "80840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2355 FACULTY DR",
"city": "US AIR FORCE",
"state": "CO",
"postal_code": "808401805",
"telephone_number": "719-333-0533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEUBAUER",
"first_name": "JAY",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-22",
"last_updated": "2024-12-23",
"certification_date": "2024-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "2083A0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Aerospace Medicine",
"state": "VA",
"license": "0101038954",
"primary": false
},
{
"code": "2083A0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Aerospace Medicine",
"state": "CO",
"license": "DR0054745",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "0054745",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "0101038954",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in US Air Force, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.