NPIMap

Individual provider Active NPI

Jennifer Skinner, PA-C

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1891458253
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0007072 Issued in CO
Practice address
12201 E Mississippi Ave Unit 107B
Aurora, CO 80012-3468
Phone
(303) 284-5338
NPI assigned
Oct 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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 PA0007072 CO Primary

Addresses

Primary practice location

12201 E Mississippi Ave Unit 107B
Aurora, CO 80012-3468

Mailing address

12201 E Mississippi Ave Unit 107B
Aurora, CO 80012-3468
Phone (303) 667-6467

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
I20220207000269 CO Practitioner - Physician Assistant 5991198426 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alpine Medical Group Colorado PLLCGroup PAC ID 1759743347, 101 clinicians

Practice addresses (Care Compare)

Denver, CO 80202
Phone (720) 728-5170

1550 S Potomac St
Suite 370
Aurora, CO 80012-5433
Phone (303) 369-1080

Hospital & facility affiliations

  • The Medical Center of Aurora & South Hospital Hospital, Aurora, CO, CCN 060100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA0007072COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Community Provider Network Inc CurrentSince Oct 14, 2022 Accepting new patients
Metro Community Provider Network, Inc. CurrentSince Oct 14, 2022 Accepting new patients
San Antonio Medical Center LLC PastSince Oct 24, 2021 Accepting new patients

Locations

3292 Peoria St
Aurora, CO 80010
Phone (303) 343-6130

2255 S Oneida St
Denver, CO 80224

17866 Cottonwood Dr
Parker, CO 80134
Phone (303) 205-6899

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.

Hospital & facility affiliations 11

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": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1891458253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 E MISSISSIPPI AVE UNIT 107B",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800123468",
            "telephone_number": "303-667-6467",
            "fax_number": "303-934-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 E MISSISSIPPI AVE UNIT 107B",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800123468",
            "telephone_number": "303-284-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0007072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.