NPIMap

Individual provider Active NPI

Jay C Johnson, M.D.

  • Diagnostic Radiology Physician
  • Durango, CO
National Provider Identifier
1669574497
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
46369 Issued in CO
Practice address
1010 Three Springs Blvd
Durango, CO 81301-8296
Phone
(970) 259-2525
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD00044954 WA
Diagnostic Radiology Physician 2085R0202X 46369 CO Primary

Addresses

Primary practice location

1010 Three Springs Blvd
Durango, CO 81301-8296

Mailing address

PO Box 394
Gretna, NE 68028-0394
Phone (877) 406-2916

Other identifiers 4

IdentifierTypeStateIssuer
P00664636OtherCORAILROAD MEDICARE
341184MedicaidAZ
51508851MedicaidCO
46280570MedicaidNM

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
I20090202000094 CO Practitioner - Diagnostic Radiology 8022100999 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Colorado School of Medicine, Denver, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of Durango PCGroup PAC ID 9335030972, 10 clinicians

Practice addresses (Care Compare)

1010 Three Springs Blvd
Durango, CO 81301-8296
Phone (970) 764-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46369COMDDiagnostic Radiology Physician
MD00044954WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of Durango PC Diagnostic Radiology CurrentSince Jul 10, 2008 Accepting new patients
Boulder Radiologists Inc P C Diagnostic Radiology CurrentSince Aug 1, 2025 Accepting new patients
Three Springs Imaging, LLC CurrentSince Sep 1, 2018 Accepting new patients
University Radiology Associates Diagnostic Radiology PastSince Feb 1, 1997 Accepting new patients
Bouldercentre for Orthopedics PC Past Accepting new patients
Southwest Diagnostic Laboratories PC Past Accepting new patients

Locations

4740 Pearl Pkwy
Ste 110
Boulder, CO 80301

1311 N Mildred Rd
Cortez, CO 81321
Phone (970) 565-6666

1010 Three Springs Blvd
Durango, CO 81301
Phone (970) 247-4311

575 Rivergate Ln
Durango, CO 81301
Phone (719) 648-5678

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1669574497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 394",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "680280394",
            "telephone_number": "877-406-2916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 THREE SPRINGS BLVD",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018296",
            "telephone_number": "970-259-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JAY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00044954",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "46369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00664636",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341184",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51508851",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46280570",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.