Unknown Individual – Medical Physician Assistant, NPI 1063415156
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Cole Blvd, Lakewood, Jefferson County, Colorado, 80401-4015, United States
LAKEWOOD, CO 804013410
Phone: (303) 379-9371
Fax: (303) 423-7004
Type: Location
Peoria Street, Aurora, Arapahoe County, Colorado, 80045, United States
#100
AURORA, CO 800145476
Phone: (303) 306-4321
Fax: (720) 524-1551
Type: Mailing
10543 KENAI SPUR HWY
KENAI, AK 996117812
Phone: (907) 395-0463
Fax: (907) 395-0483
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2023-04-13 • Largest payer in this snapshot: ABBVIE INC. ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 80401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | GA | |
| Certified Nurse Midwife (Cnm) | AK | |
| General Surgery | AK | |
| - | AL | |
| Physician Assistant | AK | |
| Physical Medicine And Rehabilitation, Sports Medicine | AK | |
| Physician Assistant | AK | |
| General Surgery | AK | |
| - | AK | |
| Physician Assistant | WA |
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