Jessica Brandon, PA
Individual provider Active NPI Physician Assistant · Colorado Springs, CO
NPI 1578721981 · NPPES record last updated Jun 2, 2008
Key facts
- NPI
- 1578721981
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2002 (CO)
- Practice address
- 104 Pro Rodeo Dr
Colorado Springs, CO 80919-2334 - Phone
- (719) 522-0707
- NPI assigned
- Jun 2, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 20
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Alpine Medical Group Colorado PLLC
Matthews-Vu Medical Group, P.C.
Select Physical Therapy of Colorado Springs LP
Practice addresses (Care Compare)
Denver, CO 80202
Phone (720) 728-5170
104 Pro Rodeo Dr
Suite 100
Colorado Springs, CO 80919-2334
Phone (719) 632-4455
4190 E Woodmen Rd
Colorado Springs, CO 80920-8075
Phone (719) 632-4455
5825 Delmonico Dr
Suite 100
Colorado Springs, CO 80919-2243
Phone (719) 257-4240
Hospital & facility affiliations
- Uch-Memorial Health System
- Centura Health-Penrose St Francis Health Services
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 |
|---|---|---|---|---|
| I20140731001749 | CO | Practitioner - Physician Assistant | 7517183312 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2002 | CO | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alpine Medical Group Colorado PLLC | Current |
Accepting new patients | |
| Matthews-Vu Medical Group, P.C. | Current |
Accepting new patients | |
| Matthews-Vu Medical Group, P.C. | Current | Accepting new patients | |
| Matthews-Vu Medical Group, PC | Current |
Accepting new patients |
Locations
104 Pro Rodeo Dr
Colorado Springs, CO 80919
Phone (719) 522-0707
4190 E Woodmen Rd
Colorado Springs, CO 80920
Phone (719) 722-2542
4190 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (630) 364-4851
104 Pro Rodeo Dr
Ste 100
Colorado Springs, CO 80919
Phone (719) 522-0707
104 Pro Rodeo Dr
Ste 120
Colorado Springs, CO 80919
Phone (719) 434-1989
999 17th St
Ste 500
Denver, CO 80202
Phone (720) 355-0539
Interoperability endpoints
- jessica.brandon@mvmg.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2002 | CO | Yes |
Addresses
Primary practice location
104 Pro Rodeo Dr
Colorado Springs, CO 80919-2334
Mailing address
104 Pro Rodeo Dr
Colorado Springs, CO 80919-2334
Phone (719) 522-0707
Other providers in Colorado Springs, CO
- Bree Branch
- Brena Jonsan Branch
- Brittany Brand
- Heather Michelle Brandenburg
- Susan Brandhorst-Neel
- Sara Jean Brandow
- Brenda Brandt
- Caitlin Elizabeth Brandt
- Katrina Brandt
- Kirsten Brandt
All providers in Colorado Springs, 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 Jun 2, 2008. 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.