Individual provider Active NPI

Haydn Jessup

  • Clinical Social Worker
  • Aurora, CO
National Provider Identifier
1881056802
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09928521 Issued in CO
Practice address
740 Peoria St
Aurora, CO 80011-8231
Phone
(720) 531-7111
Fax
(720) 640-3317
NPI assigned
Mar 28, 2016
Last updated
Nov 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW.09928521 CO Primary

Addresses

Primary practice location

740 Peoria St
Aurora, CO 80011-8231

Mailing address

PO Box 746081
Atlanta, GA 30374-6081

Other practice location 1

2087 S Federal Blvd
Denver, CO 80219-5429
Phone (720) 463-6754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221114000810 CO Practitioner - Clinical Social Worker 3375910839 Reassigns benefits to 1 organization
I20240109002768 AZ Practitioner - Clinical Social Worker 3375910839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Oak Street Health Physicians Group of Arizona PLLCGroup PAC ID 3274939988, 76 clinicians

Practice addresses (Care Compare)

183 W Apache TRL
Suite B109
Apache Junction, AZ 85120-3425
Phone (480) 618-0945

740 Peoria St
Aurora, CO 80011-8231
Phone (720) 531-7111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09928521COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group of Colorado, PLLC Clinical CurrentSince Oct 24, 2022 Accepting new patients
Oak Street Health Physicians Group of Arizona PLLC Clinical CurrentSince Nov 27, 2023 Accepting new patients
Oak Street Health Physicians Group of Colorado, PLLC Clinical CurrentSince Oct 24, 2022 Accepting new patients

Locations

183 W Apache Trl
Ste B109
Apache Junction, AZ 85120
Phone (480) 618-0945

2850 E Main St
Ste 106
Mesa, AZ 85213
Phone (480) 618-0019

3833 E Thomas Rd
Ste A2
Phoenix, AZ 85018
Phone (602) 671-7066

745 E Guadalupe Rd
Tempe, AZ 85283
Phone (480) 618-0123

2720 S 6th Ave
Tucson, AZ 85713
Phone (520) 475-5418

7040 E Golf Links Rd
Tucson, AZ 85730
Phone (520) 200-6709

3820 N Oracle Rd
Tucson, AZ 85705
Phone (520) 200-6707

740 Peoria St
Aurora, CO 80011
Phone (720) 531-7111

4380 Austin Bluffs Pkwy
Colorado Springs, CO 80918
Phone (719) 454-6010

2087 S Federal Blvd
Denver, CO 80219
Phone (720) 463-6754

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1881056802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746081",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 PEORIA ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800118231",
            "telephone_number": "720-531-7111",
            "fax_number": "720-640-3317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2087 S Federal Blvd",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802195429",
            "country_code": "US",
            "telephone_number": "720-463-6754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JESSUP",
        "first_name": "HAYDN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09928521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.