Jason D Provus, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

16633A Issued in WY

Practice address

555 E Broadway Ave Ste 129
Jackson, WY 83001-8640

Phone

(307) 733-3900

Fax

(307) 739-7683

NPI assigned

May 10, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, WY2 enrollments

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 2

Specialty

Orthopedic Surgery

Education

R Franklin University of Med & Sci/Chicago Medical School, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Teton County Hospital DistrictGroup PAC ID 4880582295, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Johns Medical Center Hospital, Jackson, WY, CCN 530015

Merit-based Incentive Payment System (MIPS)

Final score

81.82 of 100Reported as group

Quality

67.1

Promoting interoperability

98

Improvement activities

40

Cost

73.98

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Teton County Hospital District

  • General Practice Physician
  • Jackson, WY
  • NPI 1487818605
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Orthopaedic Surgery

  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1841373800

  Orthopaedic Surgery

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Teton County Hospital District

  • General Acute Care Hospital
  • Jackson, WY
  • NPI 1801835475
  NPD (past)
• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  NPD (past)

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

• Teton County Hospital District

  • General Acute Care Hospital
  • Jackson, WY
  • NPI 1801835475
  Care Compare affiliation

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709942400000",
    "number": "1972821320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830010428",
            "telephone_number": "307-733-3900",
            "fax_number": "307-739-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E BROADWAY AVE STE 129",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018640",
            "telephone_number": "307-733-3900",
            "fax_number": "307-739-7683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVUS",
        "first_name": "JASON",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-10",
        "last_updated": "2024-03-09",
        "certification_date": "2024-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WY",
            "license": "16633A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jprovus@sjmc.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "555 E Broadway Ave Ste 129",
            "city": "Jackson",
            "state": "WY",
            "country_code": "US",
            "postal_code": "830018640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Marie Potzernitz
• Brian Charles Prax, MA PT
• Madison Prescott, RBT
• Natalie Prescott, MS, PPC
• Rosanne Prince, AU.D., CCC/A
• Ivy Pruss
• Carrie Ross Quinlan, FNP-C
• Joseph W. Raboin, CRNA
• Aimee M Racette, CRNA
• Rathna Raju-Swami, MD

• Orthopaedic Surgery Physician in Jackson, WY
• Providers in Jackson, WY by specialty
• Orthopaedic Surgery Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.