NPIMap

Individual provider Active NPI

Jessica Jo Lieland, P.A.

  • Physician Assistant
  • Avila Beach, CA
National Provider Identifier
1831320878
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20448 Issued in CA
Practice address
6627 Bay Laurel Place a
Avila Beach, CA 93424-0490
Phone
(805) 540-3071
Fax
(805) 540-3072
NPI assigned
Aug 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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 PA20448 CA Primary

Addresses

Primary practice location

6627 Bay Laurel Place a
Avila Beach, CA 93424-0490

Mailing address

PO Box 490
Avila Beach, CA 93424-0490
Phone (833) 527-4387

Other practice location 1

4100 Jerry Murphy Rd
Pueblo, CO 81001-1046
Phone (719) 542-1500

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
I20220222000267 CO Practitioner - Physician Assistant 9830329085 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)

3676 Parker Blvd
Pueblo, CO 81008-2213

4100 Jerry Murphy Rd
Pueblo, CO 81001-1046
Phone (719) 542-1500

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
PA20448CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC Urology CurrentSince Jun 1, 2025 Accepting new patients
Lapidus Clinic PC Past 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

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

4100 Jerry Murphy Rd
Pueblo, CO 81001
Phone (719) 544-7070

3676 Parker Blvd
Ste 280
Pueblo, CO 81008
Phone (719) 542-1500

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

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 8

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": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1831320878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "AVILA BEACH",
            "state": "CA",
            "postal_code": "934240490",
            "telephone_number": "833-527-4387",
            "fax_number": "805-221-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6627 BAY LAUREL PLACE A",
            "city": "AVILA BEACH",
            "state": "CA",
            "postal_code": "934240490",
            "telephone_number": "805-540-3071",
            "fax_number": "805-540-3072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Jerry Murphy Rd",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810011046",
            "country_code": "US",
            "telephone_number": "719-542-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIELAND",
        "first_name": "JESSICA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avila Beach, CA

Sources for this page

Verify at the official NPI Registry.