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DR. STANLEY K JACK D.O.
NPI 1962578948
Family Medicine in Boulder, CO

Active since November 28, 2006Opted out of Medicare · through Aug 18, 2027
2995 BASELINE RD STE 200, BOULDER, CO 80303(303) 440-8243 Get Directions Write a Review

NPPES record last updated: May 5, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 5, 2025, Dec 8, 2023 (2 updates tracked since 2023).

About Dr. Stanley K Jack D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. STANLEY K JACK D.O. (NPI 1962578948) is an individual family medicine provider in Boulder, Colorado, licensed in Colorado (42877) and active in the NPI registry since November 2006. He has opted out of Medicare through August 18, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1962578948
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. STANLEY K JACKCredential: D.O.
Location Address2995 BASELINE RD STE 200Boulder, CO 80303-2318
Mailing Address2995 Baseline Rd Ste 200Boulder, CO 80303-2318 · (303) 440-8243
Phone(303) 440-8243
Sole ProprietorYes
Enumeration DateNovember 28, 2006
Last NPPES UpdateMay 5, 20252 updates tracked since enumeration
NPPES CertifiedMay 5, 2025
✔ NPI 1962578948 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CO · 42877
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2995 BASELINE RD STE 200, Boulder, CO 80303
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Stanley K Jack D.o. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 18, 2021 through August 18, 2027.

Opt-Out Effective DateAugust 18, 2021
Opt-Out In Effect ThroughAugust 18, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80303 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$89.43 typical visit price
range $58.06 – $174.82
Typical copayment $22.35 (range $14.51 – $43.70)
Most-billed visit code 99203
Established Patient
$102.03 typical visit price
range $18.88 – $142.79
Typical copayment $25.50 (range $4.72 – $35.69)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH NICHOLE TRIGG
Nurse Practitioner (Family)
2995 BASELINE RD STE 200
BOULDER, CO 80303
Boulder County (303) 440-8243
FLATIRONS SPINE & JOINT HEALTH LLC
Clinic/Center (Medical Specialty)
2995 BASELINE RD STE 200
BOULDER, CO 80303
Boulder County (303) 440-8243
JONATHAN LEJEUNE APRN
Nurse Practitioner (Family)
2995 BASELINE RD STE 200
BOULDER, CO 80303
Boulder County (303) 440-8243

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stanley Jack's NPI number?

The NPI number for Stanley Jack is 1962578948. It was assigned to this individual provider in the NPPES registry on November 28, 2006.

Where is Stanley Jack located?

Stanley Jack practices at 2995 Baseline Rd Ste 200, Boulder, CO 80303. The listed phone number is (303) 440-8243.

What is Stanley Jack's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Stanley Jack enrolled in Medicare?

No. Stanley Jack has opted out of Medicare through August 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Stanley Jack was last updated on May 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.