NPIMap

Individual provider Active NPI

Jeffrey Allen Bontrager, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Denver, CO
National Provider Identifier
1508061680
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
DR.0050240 Issued in CO
Practice address
835 E 18TH Ave Ste 110
Denver, CO 80218
Phone
(303) 825-4646
Fax
(303) 825-3215
NPI assigned
Jun 18, 2007
Last updated
Dec 4, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 50240 CO
Pediatrics Physician 208000000X 50240 CO
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X DR.0050240 CO Primary
Hospitalist Physician 208M00000X 50240 CO

Addresses

Primary practice location

835 E 18TH Ave Ste 110
Denver, CO 80218

Mailing address

835 E 18TH Ave Ste 110
Denver, CO 80218-1024
Phone (303) 825-4646

Other identifiers 1

IdentifierTypeStateIssuer
22021051MedicaidCO

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
I20111004000116 CO Practitioner - Emergency MedicinePractitioner - Internal MedicinePractitioner - HospitalistPractitioner - Pediatric Medicine 5890841472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine, Pediatric Medicine
Education
Vanderbilt University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

835 E 18TH Ave,
110 Midtown Inpatient Medicine
Denver, CO 80218-1024
Phone (303) 825-4646

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0050240COMDPediatric Emergency Medicine (Pediatrics) Physician
50240COMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Colorado Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Dec 30, 2020 Accepting new patients
University Physicians, Incorporated CurrentSince Jun 1, 2012 Accepting new patients
University Physicians Incorporated Internal Medicine CurrentSince Jun 1, 2012 Accepting new patients
Children's Hospital Colorado Past Accepting new patients
Good Samaritan Medical Center, LLC Past Accepting new patients
Intermountain Front Range, Inc. Past Accepting new patients

Locations

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

4090 Briargate Pkwy
Colorado Springs, CO 80920
Phone (719) 305-1234

835 E 18th Ave
Ste 110
Denver, CO 80218
Phone (303) 825-4646

Dept 1061
Denver, CO 80256

Interoperability endpoints

  • Direct secure messaging: jbontrager44432@direct.childrenscolorado.org

Organizations & group practices 8

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.

Hospital & facility affiliations 12

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1508061680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 E 18TH AVE STE 110",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181024",
            "telephone_number": "303-825-4646",
            "fax_number": "303-825-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 E 18TH AVE STE 110",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80218",
            "telephone_number": "303-825-4646",
            "fax_number": "303-825-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONTRAGER",
        "first_name": "JEFFREY",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "50240",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "50240",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "CO",
            "license": "DR.0050240",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "50240",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22021051",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.