NPIMap

Individual provider Active NPI

Madeline Jewell, PA-C

  • Physician Assistant
  • Greeley, CO
National Provider Identifier
1790010445
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
54566 Issued in CA
Practice address
6767 29TH St FL 3
Greeley, CO 80634-5474
Phone
(970) 652-2801
NPI assigned
Oct 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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 54566 CA Primary

Addresses

Primary practice location

6767 29TH St FL 3
Greeley, CO 80634-5474

Mailing address

PO Box 3306
Blue Jay, CA 92317
Phone (540) 632-6625

Other practice location 1

4910 Valley View Blvd NW
Roanoke, VA 24012-2040
Phone (540) 265-1607

Other practice location 2

7000 Boulder Ave
Highland, CA 92346-3348
Phone (909) 862-1191

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
I20220812002372 CO Practitioner - Physician Assistant 2264572965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

2121 E Harmony Rd
Fort Collins, CO 80528-3402
Phone (970) 482-6456

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54566CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Sep 6, 2022 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 6, 2022 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2121 E Harmony Rd
Unit 260
Fort Collins, CO 80528
Phone (970) 221-2827

6767 29th St
Fl 3
Greeley, CO 80634
Phone (970) 652-2801

6767 29th St
Ste 3
Greeley, CO 80634

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 2

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1790010445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3306",
            "city": "BLUE JAY",
            "state": "CA",
            "postal_code": "92317",
            "telephone_number": "540-632-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 29TH ST FL 3",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345474",
            "telephone_number": "970-652-2801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4910 Valley View Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240122040",
            "country_code": "US",
            "telephone_number": "540-265-1607",
            "fax_number": "540-366-7353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7000 Boulder Ave",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "CA",
            "postal_code": "923463348",
            "country_code": "US",
            "telephone_number": "909-862-1191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEWELL",
        "first_name": "MADELINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-14",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.