Individual provider Active NPI

Jennifer Ann Ray, MD

  • Dermatology Physician
  • Aurora, CO
National Provider Identifier
1962418673
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
50226 Issued in CO
Practice address
1390 S Potomac St
Ste 124
Aurora, CO 80012-6165
Phone
(303) 368-8611
Fax
(303) 368-9791
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 53513 CO
Dermatology Physician 207N00000X 50226 CO Primary

Addresses

Primary practice location

1390 S Potomac St
Ste 124
Aurora, CO 80012-6165

Mailing address

1390 S Potomac St
Ste 124
Aurora, CO 80012-6165
Phone (303) 368-8611

Other identifiers 1

IdentifierTypeStateIssuer
552607000MedicaidMN

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
I20120207000877 CO Practitioner - Dermatology 4486658291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical Branch at Galveston, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1390 S Potomac St
Suite 124
Aurora, CO 80012-4529
Phone (303) 368-8611

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as group
Quality
100
Promoting interoperability
96
Improvement activities
40
Cost
73.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1068
Removal or shaving of skin growth276
Skin biopsy46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50226COMDDermatology Physician
53513COMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology Skin Cancer & Laser Surgery Center P.C. Dermatology CurrentSince Jan 1, 2012 Accepting new patients
Advanced Dermatology Skin Cancer & Laser Surgery Center P.C. Dermatology CurrentSince Jan 1, 2012 Accepting new patients
Reese Surgical Group PLLC PastSince Feb 6, 2008 Accepting new patients

Locations

755 Maleta Ln
Ste 201
Castle Rock, CO 80108
Phone (303) 309-3072

1390 S Potomac St
Ste 124
Denver, CO 80012
Phone (303) 368-8611

3464 S Willow St
Ste 194
Denver, CO 80231

12645 E Euclid Dr
Englewood, CO 80111
Phone (303) 368-8611

30960 Stagecoach Blvd
Ste W140
Evergreen, CO 80439
Phone (303) 670-7065

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1962418673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 S POTOMAC ST",
            "address_2": "STE 124",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800126165",
            "telephone_number": "303-368-8611",
            "fax_number": "303-368-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 S POTOMAC ST",
            "address_2": "STE 124",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800126165",
            "telephone_number": "303-368-8611",
            "fax_number": "303-368-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "53513",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "50226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "552607000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.