NPIMap

Individual provider Active NPI

Jason O Lopez

  • Physician Assistant
  • Loveland, CO
National Provider Identifier
1912533076
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0009136 Issued in CO
Practice address
2500 Rocky Mountain Ave Ste 100
Loveland, CO 80538-9004
Phone
(970) 624-1800
NPI assigned
Mar 19, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 024865 NY
Physician Assistant 363A00000X PA9117464 FL
Physician Assistant 363A00000X PA.0009136 CO Primary

Addresses

Primary practice location

2500 Rocky Mountain Ave Ste 100
Loveland, CO 80538-9004

Mailing address

PO Box 917770
Orlando, FL 32891-0001
Phone (813) 821-8038

Other practice location 1

100 Woods Rd
Valhalla, NY 10595-1530
Phone (914) 493-7000

Other practice location 2

2 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 821-8038

Other identifiers 4

IdentifierTypeStateIssuer
024865OtherNYNYS EDUCATION DEPTARMENT OFFICE OF PROFESSIONS
9IGTXOtherFLBCBS
1171308OtherNATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANT (NCCPA)
119492900MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlopez278386@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL, CO3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200420001311 NY Practitioner - Physician Assistant 8820428667 Reassigns benefits to 1 organization
I20230830004360 FL Practitioner - Physician Assistant 8820428667
I20250628000410 CO Practitioner - Physician Assistant 8820428667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

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
024865NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Aug 18, 2025 Accepting new patients
Tampa General Hospital Current Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince May 1, 2020 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

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

2500 Rocky Mountain Ave
Ste 100
Loveland, CO 80538
Phone (970) 624-1800

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

Interoperability endpoints

  • Direct secure messaging: jlopez278386@direct.tgh.org
  • Direct secure messaging: jlopez3493339@direct.trinity-health.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1912533076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "813-821-8038",
            "fax_number": "813-974-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ROCKY MOUNTAIN AVE STE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389004",
            "telephone_number": "970-624-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Woods Rd",
            "address_purpose": "LOCATION",
            "city": "Valhalla",
            "state": "NY",
            "postal_code": "105951530",
            "country_code": "US",
            "telephone_number": "914-493-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063571",
            "country_code": "US",
            "telephone_number": "813-821-8038",
            "fax_number": "813-974-0483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JASON",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-19",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024865",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117464",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0009136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS EDUCATION DEPTARMENT OFFICE OF PROFESSIONS",
            "identifier": "024865",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9IGTX",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL COMMISSION ON   CERTIFICATION OF PHYSICIAN ASSISTANT (NCCPA)",
            "identifier": "1171308",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119492900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlopez278386@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.