Basic Information
| Provider Information | |||||||||
| NPI: | 1639127574 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEHLING | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | AARON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 36 GARDEN CTR | ||||||||
| Address2: | |||||||||
| City: | BROOMFIELD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800201730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034650401 | ||||||||
| FaxNumber: | 3034381351 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 BALSAM AVE | ||||||||
| Address2: | |||||||||
| City: | BOULDER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 803043404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035323500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 07/05/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0204X | 48305 | MN | Y | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology |
ID Information
| ID | Type | State | Issuer | Description | 450818YULQ | 01 | MEDICARE BRI | OTHER | 1604152 | 01 | MN | MEDICA | OTHER | 39730069 | 05 | CO | MEDICAID | 0720953 | 05 | IA | MEDICAID | 348484000 | 05 | WI | MEDICAID | HP62576 | 01 | MN | HEALTHPARTNERS | OTHER | 127660300 | 05 | MN | MEDICAID | P00318045 | 01 | MN | RAILROAD MEDICARE MN | OTHER | 113311 | 01 | MN | UCARE | OTHER | 1046708 | 01 | MN | PREFERRED ONE | OTHER | 2443320 | 01 | MN | AMERICA'S PPO | OTHER | 507P3ME | 01 | MN | BLUE CROSS BLUE SHIELD | OTHER | 99112127 | 01 | WI | WI HEALTH INSURANCE RISK SHARING PLAN | OTHER | P00380132 | 01 | WI | RAILROAD MEDICARE WI | OTHER | 1639127574 | 01 | MN | MEDICA | OTHER | P01559590 | 01 | CO | BRI MEDICARE RAILROAD | OTHER |