NPIMap

Individual provider Active NPI

Jarred Marshal Freese, M.D.

  • Internal Medicine Physician
  • Delta, CO
National Provider Identifier
1821230475
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR0050766 Issued in CO
Practice address
1501 E 3Rd St
Delta, CO 81416-2815
Phone
(702) 453-3799
Fax
(702) 453-5741
NPI assigned
Mar 28, 2009
Last updated
Apr 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR0050766 CO Primary
Hospitalist Physician 208M00000X 50766 CO

Addresses

Primary practice location

1501 E 3Rd St
Delta, CO 81416-2815

Mailing address

PO Box 343
Montrose, CO 81402-0343
Phone (702) 453-3799

Other identifiers 1

IdentifierTypeStateIssuer
50766OtherCOCO LICENSE

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
I20120813000773 CO Practitioner - Internal Medicine 4082860705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delta County Memorial HospitalGroup PAC ID 1850200601, 107 clinicians

Practice addresses (Care Compare)

1450 Burgess St
Delta, CO 81416-2849
Phone (970) 874-7668

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR0050766COMDInternal Medicine Physician
50766COMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delta County Memorial Hospital CurrentSince Aug 1, 2012 Accepting new patients
Delta County Memorial Hospital CurrentSince Aug 1, 2012 Accepting new patients
Delta County Memorial Hospital Internal Medicine Past Accepting new patients
Delta County Memorial Hospital Past Accepting new patients

Locations

1450 Burgess St
Delta, CO 81416
Phone (970) 874-7668

1501 E 3rd St
Delta, CO 81416
Phone (970) 874-2470

296 Stafford Ln
Delta, CO 81416
Phone (970) 874-4399

296 Stafford Ln
Ste B
Delta, CO 81416
Phone (970) 874-4427

230 Hotchkiss Ave
Hotchkiss, CO 81419
Phone (970) 872-1400

Interoperability endpoints

  • Direct secure messaging: jarred.freese.1@12539.direct.athenahealth.com

Organizations & group practices 4

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1238198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1821230475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 343",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814020343",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E 3RD ST",
            "city": "DELTA",
            "state": "CO",
            "postal_code": "814162815",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREESE",
        "first_name": "JARRED",
        "middle_name": "MARSHAL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-28",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR0050766",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "50766",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO LICENSE",
            "identifier": "50766",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delta, CO

Sources for this page

Verify at the official NPI Registry.