Individual provider Active NPI

Jeremy Sloan Hubbard, PA-C

  • Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1962835793
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0003962 Issued in CO
Practice address
1633 Medical Center PT
Colorado Springs, CO 80907-5700
Phone
(719) 228-0400
Fax
(719) 667-4155
NPI assigned
Aug 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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 PA.0003962 CO Primary

Addresses

Primary practice location

1633 Medical Center PT
Colorado Springs, CO 80907-5700

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3253

Other identifiers 1

IdentifierTypeStateIssuer
91983088MedicaidCO

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141009000243 CO Practitioner - Physician Assistant 0446486708 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Colorado Medical Group LLCGroup PAC ID 2769706431, 187 clinicians

Practice addresses (Care Compare)

1625 Medical Ctr PT
Suite 290
Colorado Springs, CO 80907-8722
Phone (719) 635-5148

1633 Medical Ctr PT
Colorado Springs, CO 80907-5700
Phone (719) 598-9446

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0003962COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers CurrentSince Sep 22, 2014 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Jan 25, 2016 Accepting new patients
Optumcare Colorado Medical Group LLC CurrentSince Jan 25, 2016 Accepting new patients
Peak Vista Community Health Centers CurrentSince Sep 22, 2014 Accepting new patients
Bobcat Emergency Physicians LLC Physician Assistant Past Accepting new patients
Optumcare Colorado Medical Group LLC Past Accepting new patients
Optumcare Colorado Medical Group LLC Past Accepting new patients

Locations

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

1633 Medical Center Pt
Colorado Springs, CO 80907
Phone (719) 636-2999

2 S Cascade Ave
Ste 140
Colorado Springs, CO 80903
Phone (719) 538-2900

1625 Medical Center Pt
Ste 290
Colorado Springs, CO 80907
Phone (719) 635-5148

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

1625 Medical Center Pt
Ste 200
Colorado Springs, CO 80907
Phone (719) 630-3276

Interoperability endpoints

  • Direct secure messaging: jhubbard120944@westdirect.optum.com

Organizations & group practices 7

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": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1962835793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 MEDICAL CENTER PT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075700",
            "telephone_number": "719-228-0400",
            "fax_number": "719-667-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "JEREMY",
        "middle_name": "SLOAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-15",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0003962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91983088",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.