Jennifer L McCarthy, P.A.-C
Individual provider Active NPI Physician Assistant · Divide, CO
NPI 1548337249 · NPPES record last updated Apr 4, 2017
Key facts
- NPI
- 1548337249
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2997 (CO)
- Practice address
- 34 Hybrook Rd South
Divide, CO 80814 - Phone
- (719) 632-5700
- Fax
- (719) 344-7817
- NPI assigned
- Nov 29, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 29
Hospital & facility affiliations 19
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of New England, College of Osteo Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Peak Vista Community Health Centers
Select Physical Therapy of West Denver Limited Partnership
Practice addresses (Care Compare)
1400 E Boulder
Colorado Springs, CO 80909-5533
Phone (719) 776-5000
34 Hybrook Rd S
Divide HLTH Ctr
Divide, CO 80814-9219
Phone (719) 687-4460
406 E Grace Ave
Select Physical Therapy
Woodland Park, CO 80863-3127
Phone (719) 687-3767
Hospital & facility affiliations
- Uchealth Pikes Peak Regional Hospital
- Uch-Memorial Health System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100817000654 | CO | Practitioner - Physician Assistant | 2860563111 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2997 | CO | MD | Physician Assistant |
| PA9103485 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Vista Community Health Centers | Current |
Accepting new patients | |
| Peak Vista Community Health Centers | Current |
Accepting new patients | |
| Peak Vista Community Health Centers | Past | Accepting new patients |
Locations
1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120
340 Printers Pkwy
Colorado Springs, CO 80910
Phone (719) 228-6635
3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873
34 Hybrook Rd S
Divide, CO 80814
Phone (719) 687-4460
Interoperability endpoints
- jennifer.mccarthy.p1@direct.peakvista.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9103485 | FL | |
| Physician Assistant | 363A00000X | 2997 | CO | Yes |
Addresses
Primary practice location
34 Hybrook Rd South
Divide, CO 80814
Mailing address
3205 N Academy Blvd
Suite 130
Colorado Springs, CO 80917-5101
Phone (719) 632-5700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| COA101228 | Other | CO | MEDICARE NUMBER |
| 46681230 | Medicaid | CO | |
| 57561Z | Other | FL | MEDICARE |
Other providers in Divide, CO
- Stacey Knapp
- Ione Renee Lafata
- Christina Lesea
- Lisa Lior Lima
- Cheryl Maniak
- Roy McMurtry
- Patricia Diahann Moore
- Mountaintop Autism Partners LLC
- Mountaintop Autism Partners LLC
- Mountaintop Autism Partners LLC
All providers in Divide, CO · Physician Assistant in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.