Jane D Brockhausen, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0001833 Issued in CO

Practice address

5799 Stetson Hills Blvd Ste 100
Colorado Springs, CO 80917-4223

Phone

(719) 471-2273

Fax

(719) 380-0228

NPI assigned

May 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Front Range Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Colorado Springs, CO
  • NPI 1457665713

  CO

  Medicare reassignment
• Front Range Urgent Care, Inc

  • Durable Medical Equipment & Medical Supplies
  • Pueblo, CO
  • NPI 1518706092
  NPD
• Front Range Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Colorado Springs, CO
  • NPI 1699319590
  NPD

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1770538159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5799 STETSON HILLS BLVD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809174223",
            "telephone_number": "719-471-2273",
            "fax_number": "719-380-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5799 STETSON HILLS BLVD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809174223",
            "telephone_number": "719-471-2273",
            "fax_number": "719-380-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKHAUSEN",
        "first_name": "JANE",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "0001833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Brock
• Mikaela Jade Brock
• Peter Andrew Brock, FNP-C
• Samantha De Vel Brock, DPT
• Dylan Brockel
• Victoria Brockmeyer
• Elisabeth Brockway
• Teresa Brockway
• Trisha Broderick, LPN
• Alyson Michelle Brodey, MSN-NNP-BC

• Medical Physician Assistant in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.