NPIMap

Individual provider Active NPI

Jacob Roddy

  • Surgical Physician Assistant
  • Englewood, CO
National Provider Identifier
1972186161
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0007444 Issued in CO
Practice address
175 Inverness Dr W Ste 200
Englewood, CO 80112-5069
Phone
(720) 848-0000
NPI assigned
May 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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
Student in an Organized Health Care Education/Training Program 390200000X
Surgical Physician Assistant 363AS0400X PA.0007444 CO Primary

Addresses

Primary practice location

175 Inverness Dr W Ste 200
Englewood, CO 80112-5069

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

13001 E 17th Pl
Aurora, CO 80045-2570
Phone (303) 724-7963

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
I20221026001056 CO Practitioner - Physician Assistant 3678949005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

1635 Aurora CT
Aurora, CO 80045-2541
Phone (720) 848-0000

175 Inverness Dr West
200 Cu Medicine Steadman Hawkins Ortho and SP
Englewood, CO 80112-5065
Phone (303) 694-3333

9548 Park Meadows Dr
Lone Tree, CO 80124-5315
Phone (720) 848-2200

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024
  • Uchealth Highlands Ranch Hospital Hospital, Highlands Ranch, CO, CCN 060132

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0007444COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated CurrentSince Nov 1, 2022 Accepting new patients
University Physicians, Incorporated Hand Surgery CurrentSince Nov 1, 2022 Accepting new patients
University Physicians Incorporated Physician Assistant Past Accepting new patients

Locations

1635 Aurora Ct
Fl 4
Aurora, CO 80045
Phone (720) 848-2000

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

1635 Aurora Ct
Fl 6
Aurora, CO 80045
Phone (720) 848-2650

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

175 Inverness Dr W
Ste 200
Englewood, CO 80112
Phone (303) 469-3182

1500 Park Central Dr
Ste 401
Highlands Ranch, CO 80129
Phone (720) 516-4085

1500 Park Central Dr
Littleton, CO 80129
Phone (720) 516-1000

9548 Park Meadows Dr
Lone Tree, CO 80124
Phone (720) 848-2200

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.

Hospital & facility affiliations 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1972186161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 INVERNESS DR W STE 200",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801125069",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13001 E 17th Pl",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452570",
            "country_code": "US",
            "telephone_number": "303-724-7963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODDY",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-04",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0007444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.