NPIMap

Individual provider Active NPI

Kelly C Jeong, MD

  • Internal Medicine Physician
  • Arvada, CO
National Provider Identifier
1487781431
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0038762 Issued in CO
Practice address
8175 Sheridan Blvd Unit N
Arvada, CO 80003-1928
Phone
(303) 557-0855
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0038762 CO Primary

Addresses

Primary practice location

8175 Sheridan Blvd Unit N
Arvada, CO 80003-1928

Mailing address

8175 Sheridan Blvd Unit N
Arvada, CO 80003-1928
Phone (303) 557-0855

Other practice location 1

14300 Orchard Pkwy Fl 2
Westminster, CO 80023-9206
Phone (720) 627-4921

Other identifiers 2

IdentifierTypeStateIssuer
012280OtherKAISER-COMMERCIAL NUMBER
83538526MedicaidCO

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
I20110314000228 CO Practitioner - Internal Medicine 4880876705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Miami, LM Miller School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

11310 Huron St
Suite 100
Northglenn, CO 80234-3090
Phone (303) 450-7435

Hospital & facility affiliations

  • Centura Health-St Anthony North Health Campus Hospital, Westminster, CO, CCN 060104

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0038762COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Oct 1, 2024 Accepting new patients
Catholic Health Initiatives Colorado Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Iora Health, LLC Internal Medicine Past Accepting new patients
Iora Health Massachusetts, P.C. Internal Medicine Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

11310 Huron St
Ste 100
Northglenn, CO 80234
Phone (303) 254-2664

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 6

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1487781431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 SHERIDAN BLVD UNIT N",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800031928",
            "telephone_number": "303-557-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8175 SHERIDAN BLVD UNIT N",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800031928",
            "telephone_number": "303-557-0855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14300 Orchard Pkwy Fl 2",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "CO",
            "postal_code": "800239206",
            "country_code": "US",
            "telephone_number": "720-627-4921",
            "fax_number": "720-627-4922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEONG",
        "first_name": "KELLY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0038762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "012280",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83538526",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

Verify at the official NPI Registry.