NPIMap

Individual provider Active NPI

Jodi Leigh McConnell, PA

  • Surgical Physician Assistant
  • Boulder, CO
National Provider Identifier
1487661971
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0001177 Issued in CO
Practice address
2150 Stadium Drive
Boulder, CO 80309-5437
Phone
(303) 315-9000
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1177 CO
Surgical Physician Assistant 363AS0400X PA.0001177 CO Primary

Addresses

Primary practice location

2150 Stadium Drive
Boulder, CO 80309-5437

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

2045 N Franklin St
Denver, CO 80205-5437
Phone (303) 338-4545

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040727000532 CO Practitioner - Physician Assistant 8123098332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024
  • Uchealth Broomfield Hospital Hospital, Broomfield, CO, CCN 060129
  • Longs Peak Hospital Hospital, Longmont, CO, CCN 060128

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1177COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated Sports Medicine CurrentSince Apr 1, 2024 Accepting new patients
University Physicians Incorporated CurrentSince Apr 1, 2024 Accepting new patients
University Physicians, Incorporated Past Accepting new patients
University Physicians Incorporated Physician Assistant Past Accepting new patients

Locations

1635 Aurora Ct
Fl 4
Aurora, CO 80045
Phone (720) 848-2000

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

5495 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-4515

5495 Arapahoe Ave
Fl 2
Boulder, CO 80303
Phone (720) 848-9200

Organizations & group practices 4

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 29

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1487661971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 STADIUM DRIVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803095437",
            "telephone_number": "303-315-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2045 N Franklin St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802055437",
            "country_code": "US",
            "telephone_number": "303-338-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "JODI",
        "middle_name": "LEIGH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1177",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0001177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.