NPIMap

Individual provider Active NPI

Jona S Nykreim, PA

  • Physician Assistant
  • Eagle, CO
National Provider Identifier
1871535781
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1851 Issued in CO
Practice address
377 Sylvan Lake Rd Ste 210
Eagle, CO 81631-6779
Phone
(970) 926-6340
Fax
(970) 926-6348
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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 1851 CO Primary

Addresses

Primary practice location

377 Sylvan Lake Rd Ste 210
Eagle, CO 81631-6779

Mailing address

PO Box 4330
Avon, CO 81620-4330
Phone (970) 926-6340

Other practice location 1

50 Buck Creek Road
Suite 200
Avon, CO 81620
Phone (970) 926-6340

Other identifiers 1

IdentifierTypeStateIssuer
47851252MedicaidCO

Other names 1

  • Jona N Moore Former name

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
I20090108000581 CO Practitioner - Physician Assistant 6709949365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Colorado Mountain Medical, LLCGroup PAC ID 5496087181, 63 clinicians

Practice addresses (Care Compare)

181 W Meadow Dr
Vail, CO 81657-5242
Phone (970) 926-6340

377 Sylvan Lake Rd
Eagle, CO 81631-6779
Phone (970) 926-6350

Hospital & facility affiliations

  • Vail Health Hospital Hospital, Vail, CO, CCN 060096
  • Valley View Hospital Association Hospital, Glenwood Springs, CO, CCN 060075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1851COMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Mountain Medical, LLC CurrentSince Aug 17, 2019 Accepting new patients
Colorado Mountain Medical, LLC CurrentSince Aug 17, 2019 Accepting new patients
Colorado Mountain Medical, LLC PastSince Sep 8, 2019 Accepting new patients

Locations

377 Sylvan Lake Rd
Ste 210
Eagle, CO 81631
Phone (970) 328-1650

377 Sylvan Lake Rd
Ste 120
Eagle, CO 81631
Phone (970) 926-1800

181 W Meadow Dr
Vail, CO 81657
Phone (970) 476-1225

Interoperability endpoints

  • Direct secure messaging: jonanykreim@coloradomo.allscriptsdirect.net

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 7

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1871535781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4330",
            "city": "AVON",
            "state": "CO",
            "postal_code": "816204330",
            "telephone_number": "970-926-6340",
            "fax_number": "970-926-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 SYLVAN LAKE RD STE 210",
            "city": "EAGLE",
            "state": "CO",
            "postal_code": "816316779",
            "telephone_number": "970-926-6340",
            "fax_number": "970-926-6348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Buck Creek Road",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "CO",
            "postal_code": "81620",
            "country_code": "US",
            "telephone_number": "970-926-6340",
            "fax_number": "970-926-6348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYKREIM",
        "first_name": "JONA",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47851252",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JONA",
            "last_name": "MOORE",
            "middle_name": "N",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eagle, CO

Sources for this page

Verify at the official NPI Registry.