NPIMap

Individual provider Active NPI

Jennifer J Smith, PA

  • Physician Assistant
  • Loveland, CO
National Provider Identifier
1508274028
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3998 Issued in CO
Practice address
2000 Boise Ave
Loveland, CO 80538-5006
Phone
(970) 810-3894
Fax
(970) 810-3897
NPI assigned
Jul 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3998 CO
Physician Assistant 363A00000X 3998 CO Primary

Addresses

Primary practice location

2000 Boise Ave
Loveland, CO 80538-5006

Mailing address

2000 Boise Ave
Loveland, CO 80538-5006
Phone (970) 810-3894

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
I20160705000045 CO Practitioner - Physician Assistant 3971895426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4593

2000 Boise Ave
Loveland, CO 80538-5006
Phone (970) 820-4640

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.9 of 100Reported as group
Quality
79.21
Promoting interoperability
99
Improvement activities
40
Cost
77.28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3998COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Jul 8, 2019 Accepting new patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Jul 8, 2019 Accepting new patients
Radiology Imaging Associates, PC Past Accepting new patients
Banner Hospital Based Physicians Colorado LLC Past Accepting new patients
Medical Imaging of Colorado Radiology Imaging Assc PC Etal PT Past Accepting new patients

Locations

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

2000 Boise Ave
Loveland, CO 80538
Phone (970) 635-4071

Organizations & group practices 5

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1508274028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 BOISE AVE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805385006",
            "telephone_number": "970-810-3894",
            "fax_number": "970-810-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 BOISE AVE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805385006",
            "telephone_number": "970-810-3894",
            "fax_number": "970-810-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2023-03-07",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "3998",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "3998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.