Individual provider Active NPI

Jane Elizabeth Nydam, MD

  • Pediatric Cardiology Physician
  • Aurora, CO
National Provider Identifier
1881740496
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
DR.46631 Issued in CO
Practice address
13123 E 16TH Ave
Aurora, CO 80045-7106
Phone
(720) 777-1234
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X DR.46631 CO Primary

Addresses

Primary practice location

13123 E 16TH Ave
Aurora, CO 80045-7106

Mailing address

2055 N High St
Suite 255
Denver, CO 80205-5503
Phone (303) 860-9933

Other practice location 1

2055 N High St
Suite 255
Denver, CO 80205-5503
Phone (303) 860-9933

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090107000199 CO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 9537220389 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.46631COMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated Current Accepting new patients
University Physicians Incorporated CurrentSince Aug 1, 2022 Accepting new patients
Children'S Hospital Colorado Current Accepting new patients
University Physicians, Incorporated CurrentSince Aug 1, 2022 Accepting new patients
Children'S Hospital Colorado Past Accepting new patients

Locations

13123 E 16th Ave
#B450
Aurora, CO 80045

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

1501 S Potomac St
Denver, CO 80012
Phone (303) 695-2604

Dept 1061
Denver, CO 80256

501 E Hampden Ave
Englewood, CO 80113
Phone (303) 788-5300

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

1811 Plaza Dr
Highlands Ranch, CO 80129
Phone (720) 478-0108

10101 Ridgegate Pkwy
Lone Tree, CO 80124
Phone (720) 225-1000

2301 House Ave
Ste 400
Cheyenne, WY 82001
Phone (307) 634-5216

Interoperability endpoints

  • Direct secure messaging: jnydam1581@direct.childrenscolorado.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1881740496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 N HIGH ST",
            "address_2": "SUITE 255",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055503",
            "telephone_number": "303-860-9933",
            "fax_number": "303-839-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 N High St",
            "address_2": "Suite 255",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802055503",
            "country_code": "US",
            "telephone_number": "303-860-9933",
            "fax_number": "303-839-5844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYDAM",
        "first_name": "JANE",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CO",
            "license": "DR.46631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.