NPIMap

Individual provider Active NPI

Jonathan Raphael Fox, PA

  • Physician Assistant
  • Durango, CO
National Provider Identifier
1780795500
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
883 Issued in CO
Practice address
1970 E 3Rd Ave Ste 1
Durango, CO 81301-5049
Phone
(970) 444-0260
NPI assigned
Aug 31, 2006
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 883 CO Primary

Addresses

Primary practice location

1970 E 3Rd Ave Ste 1
Durango, CO 81301-5049

Mailing address

PO Box 844088
Dallas, TX 75284-4088
Phone (505) 609-2258

Other practice location 1

1485 Florida Rd Ste 103A
Durango, CO 81301
Phone (870) 444-0260

Other practice location 2

1010 Three Springs Blvd
Durango, CO 81301-8296
Phone (970) 247-4311 ext. 2100

Other identifiers 2

IdentifierTypeStateIssuer
S4634MedicaidNM
07008832MedicaidCO

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
I20040315000295 CO Practitioner - Physician Assistant 3678462801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1970 E 3Rd Ave
1 San Juan Health Partners Family and Speci
Durango, CO 81301-5049
Phone (970) 444-0260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
79.73
Promoting interoperability
100
Improvement activities
40
Cost
78.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
883COMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Regional Medical Center Inc CurrentSince Jun 12, 2024 Accepting new patients
San Juan Regional Medical Center Inc CurrentSince Jun 12, 2024 Accepting new patients
San Juan Regional Medical Center Inc Past Accepting new patients
Southwest Emergency Physicians, PC Physician Assistant Past Accepting new patients
San Juan Regional Medical Center Inc Past Accepting new patients

Locations

1970 E 3rd Ave
Ste 1
Durango, CO 81301
Phone (970) 335-2288

Organizations & group practices 5

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 6

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1780795500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844088",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844088",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 E 3RD AVE STE 1",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015049",
            "telephone_number": "970-444-0260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1485 Florida Rd Ste 103A",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "81301",
            "country_code": "US",
            "telephone_number": "870-444-0260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 Three Springs Blvd",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "813018296",
            "country_code": "US",
            "telephone_number": "970-247-4311 x2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOX",
        "first_name": "JONATHAN",
        "middle_name": "RAPHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S4634",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07008832",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.