NPIMap

Individual provider Active NPI

Jacan Simon, DO

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1669969085
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0066716 Issued in CO
Practice address
1815 Jet Wing Dr
Colorado Springs, CO 80916-2300
Phone
(719) 632-5700
Fax
(719) 344-7887
NPI assigned
Apr 20, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X
Family Medicine Physician 207Q00000X 66237 MN
Family Medicine Physician 207Q00000X DR.0066716 CO Primary

Addresses

Primary practice location

1815 Jet Wing Dr
Colorado Springs, CO 80916-2300

Mailing address

3205 N Academy Blvd Ste 130
Colorado Springs, CO 80917-5152
Phone (719) 632-5700

Other practice location 1

101 Martin Luther King Dr
Mankato, MN 56001-6460
Phone (507) 594-6500

Other practice location 2

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

Other practice location 3

3027 N Circle Dr
Colorado Springs, CO 80909-1179
Phone (719) 776-4646

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
I20210614002031 CO Practitioner - Family Practice 5294082624 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peak Vista Community Health CentersGroup PAC ID 4688583974, 126 clinicians
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

1400 E Boulder
Colorado Springs, CO 80909-5533
Phone (719) 776-5000

1815 Jet Wing Dr
Colorado Springs, CO 80916-2300
Phone (719) 632-5700

3027 N Circle Dr
Centura Endocrinology Colorado Spri
Colorado Springs, CO 80909-1179
Phone (719) 776-4700

Hospital & facility affiliations

  • Centura Health-Penrose St Francis Health Services Hospital, Colorado Springs, CO, CCN 060031
  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0066716COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers Single Specialty CurrentSince Jun 7, 2021 Accepting new patients
Peak Vista Community Health Centers CurrentSince Jun 7, 2021 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Oct 1, 2025 Accepting new patients
Catholic Health Initiatives Colorado Single Specialty Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Oct 1, 2025 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Single Specialty Past Accepting new patients

Locations

1815 Jet Wing Dr
Colorado Springs, CO 80916
Phone (719) 344-6331

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

3027 N Circle Dr
Colorado Springs, CO 80909
Phone (719) 577-2555

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 7

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1669969085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD STE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175152",
            "telephone_number": "719-632-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 JET WING DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162300",
            "telephone_number": "719-632-5700",
            "fax_number": "719-344-7887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Martin Luther King Dr",
            "address_purpose": "LOCATION",
            "city": "Mankato",
            "state": "MN",
            "postal_code": "560016460",
            "country_code": "US",
            "telephone_number": "507-594-6500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Marsh St",
            "address_purpose": "LOCATION",
            "city": "Mankato",
            "state": "MN",
            "postal_code": "560014752",
            "country_code": "US",
            "telephone_number": "507-625-4031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3027 N Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809091179",
            "country_code": "US",
            "telephone_number": "719-776-4646",
            "fax_number": "719-776-4640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JACAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-20",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "66237",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0066716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.