NPIMap

Individual provider Active NPI

Jerry S Miklin, M.D.

  • Interventional Cardiology Physician
  • Wheat Ridge, CO
National Provider Identifier
1689631822
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
25248 Issued in CO
Practice address
3655 Lutheran Pkwy
Suite 201
Wheat Ridge, CO 80033-6018
Phone
(303) 603-9800
Fax
(303) 403-6209
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25248 CO
Interventional Cardiology Physician 207RI0011X 25248 CO Primary
Nuclear Cardiology Physician 207UN0901X 25248 CO

Addresses

Primary practice location

3655 Lutheran Pkwy
Suite 201
Wheat Ridge, CO 80033-6018

Mailing address

500 Eldorado Blvd
Suite 6250
Broomfield, CO 80021-3408
Phone (303) 272-0750

Other identifiers 1

IdentifierTypeStateIssuer
01252485MedicaidCO

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
I20090304000841 CO Practitioner - Cardiovascular Disease (Cardiology) 8325136203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Colorado School of Medicine, Denver, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platte Valley Medical Group LLCGroup PAC ID 5890054100, 120 clinicians

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

11900 Grant St
Northglenn, CO 80233-1117

12905 W 40TH Ave
Wheat Ridge, CO 80401-2793

1600 Prairie Ctr Pkwy
Brighton, CO 80601-4006
Phone (303) 498-1600

1610 Prairie Ctr Pkwy
Brighton, CO 80601-4003

1818 N Ogden St
Suite 400
Denver, CO 80218-1280
Phone (303) 318-2460

300 Exempla Cir
310 Imh Heart and Vascular Institute Lafayatt
Lafayette, CO 80026-3394
Phone (303) 272-0500

4859 Yampa St
Denver, CO 80249-7760
Phone (303) 498-1885

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting22
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25248COMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Platte Valley Medical Group, LLC CurrentSince Jan 1, 2021 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Dec 1, 2014 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Dec 1, 2014 Accepting new patients
Intermountain Medical Group Denver, LLC Cardiovascular Disease Current Accepting new patients
Platte Valley Medical Group, LLC CurrentSince Jan 1, 2021 Accepting new patients
West Denver Ekg Panel Cardiovascular Disease Past Accepting new patients
Rose Interpretation Group Cardiovascular Disease Past Accepting new patients
Rocky Mountain Heart Associates, P.C. Cardiovascular Disease Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 6250
Broomfield, CO 80021
Phone (303) 272-0750

4859 Yampa St
Denver, CO 80249
Phone (303) 498-1885

1000 Lincoln St
Fort Morgan, CO 80701
Phone (970) 542-3320

12905 W 40th Ave
Ste 305
Golden, CO 80401
Phone (303) 265-5730

200 Exempla Cir
Lafayette, CO 80026
Phone (303) 689-4110

8300 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 425-2015

3655 Lutheran Pkwy
Ste 201
Wheat Ridge, CO 80033
Phone (303) 420-0206

Interoperability endpoints

  • Direct secure messaging: jmiklin6564@direct.intermountainhealth.org

Organizations & group practices 8

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 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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1689631822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ELDORADO BLVD",
            "address_2": "SUITE 6250",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800213408",
            "telephone_number": "303-272-0750",
            "fax_number": "303-318-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 LUTHERAN PKWY",
            "address_2": "SUITE 201",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336018",
            "telephone_number": "303-603-9800",
            "fax_number": "303-403-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKLIN",
        "first_name": "JERRY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "25248",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CO",
            "license": "25248",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "CO",
            "license": "25248",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01252485",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.