NPIMap

Individual provider Active NPI

Jeanine Catherine Hjelt

  • Medical Physician Assistant
  • Greeley, CO
National Provider Identifier
1821231333
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0005289 Issued in CO
Practice address
6767 29TH St FL 2
Greeley, CO 80634-5474
Phone
(970) 224-9102
Fax
(970) 224-9112
NPI assigned
Apr 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4342 AZ
Medical Physician Assistant 363AM0700X PA889 WY
Medical Physician Assistant 363AM0700X PA.0005289 CO Primary

Addresses

Primary practice location

6767 29TH St FL 2
Greeley, CO 80634-5474

Mailing address

6767 29TH St FL 2
Greeley, CO 80634-5474
Phone (970) 224-9102

Other identifiers 1

IdentifierTypeStateIssuer
9000158652MedicaidCO

Other names 1

  • Jeanine Catherine Poplau Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CO, WY3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20110830000780 AZ Practitioner - Physician Assistant 8527238518 Reassigns benefits to 1 organization
I20180404002541 CO Practitioner - Physician Assistant 8527238518 Reassigns benefits to 1 organization
I20210111001284 WY Practitioner - Physician Assistant 8527238518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
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, shared by 2 NPIs, 2,425 clinicians

Practice addresses (Care Compare)

2121 E Harmony Rd
Fort Collins, CO 80528-3403

3116 Willett Dr
Laramie, WY 82072-5048
Phone (307) 742-9411

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

5050 Powderhouse Rd
Cheyenne, WY 82009-4800
Phone (307) 634-1311

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-3636

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4342AZMDGeneral Practice Dentistry
PA.0005289COMDMedical Physician Assistant
PA889WYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince May 7, 2018 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince May 7, 2018 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 300
Fort Collins, CO 80528
Phone (970) 224-0429

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

6767 29th St
Fl 2
Greeley, CO 80634
Phone (970) 652-2433

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

2500 Rocky Mountain Ave
Ste 300
Loveland, CO 80538
Phone (970) 619-6100

3116 Willett Dr
Laramie, WY 82072
Phone (307) 742-6319

Organizations & group practices 3

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": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1821231333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 29TH ST FL 2",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345474",
            "telephone_number": "970-224-9102",
            "fax_number": "970-224-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 29TH ST FL 2",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345474",
            "telephone_number": "970-224-9102",
            "fax_number": "970-224-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HJELT",
        "first_name": "JEANINE",
        "middle_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-14",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4342",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "PA889",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0005289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000158652",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANINE",
            "last_name": "POPLAU",
            "middle_name": "CATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.