NPIMap

Individual provider Active NPI

Jessica Dartoozos, PA-C

  • Medical Physician Assistant
  • Aurora, CO
National Provider Identifier
1710609284
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0007586 Issued in CO
Practice address
12505 E 16TH Ave
Aurora, CO 80045-2545
Phone
(720) 842-0000
NPI assigned
Sep 13, 2022
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0007586 CO
Medical Physician Assistant 363AM0700X PA.0007586 CO Primary

Addresses

Primary practice location

12505 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

2770 N Powers Blvd
Colorado Springs, CO 80922-2802
Phone (719) 638-3000

Other practice location 2

11820 Destination Dr
Broomfield, CO 80021-2518
Phone (720) 848-0000

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
I20221213002148 CO Practitioner - Physician Assistant 9032588066 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as group
Quality
94.16
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0007586COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Specialists, PC CurrentSince Dec 1, 2022 Accepting new patients
University Physicians Incorporated CurrentSince Jan 17, 2025 Accepting new patients
University Physicians, Incorporated CurrentSince Jan 17, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Mar 3, 2025 Accepting new patients
Emergency Medical Specialists, PC CurrentSince Dec 1, 2022 Accepting new patients

Locations

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

11820 Destination Dr
Broomfield, CO 80021
Phone (303) 460-6000

2770 N Powers Blvd
Colorado Springs, CO 80922
Phone (719) 638-3000

4050 Briargate Pkwy
Colorado Springs, CO 80920
Phone (719) 364-5000

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

NPI Registry JSON

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1710609284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-842-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2770 N Powers Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809222802",
            "country_code": "US",
            "telephone_number": "719-638-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11820 Destination Dr",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800212518",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "fax_number": "303-460-6197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DARTOOZOS",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007586",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0007586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.