WILLIAM ABBOTT

NPI 1013992361 · Emergency Medicine · Uhc Colorado

Provider Status Assessment

Needs Review

Evidence across dimensions is contradictory — supporting and opposing signals are present.

Confidence: High

Evidence: 68 items from 10 sources

Signals: 5 supporting · 0 opposing · 1 missing

Resolution: Mixed signals across dimensions prevent confident classification. Manual review recommended.

Data Source Signals

✓

NPPES

AURORA, 80014

Freshness: Unknown

✓

Network Status

Listed with 6 carriers

uhc_colorado_co — in_network (commercial)
uhc_insurance_co — in_network (commercial)
uhc_services_co — in_network (commercial)
uhc_umr_co — in_network (commercial)
uhc_surest_co — in_network (commercial)
kaiser_co — in_network (commercial)

✓

DORA License

Active

✗

Medicare

Enrolled but no billing activity

—

Care Compare

No Care Compare data

✓

PECOS Enrollment

Medicare enrolled

System Reasoning

Claim Under Evaluation

Provider is actively practicing and appropriately listed in carrier networks

Evidence Evaluated

Medicare Billing: Enrolled in Medicare but no recent billing data

FHIR Directory: No active FHIR endpoint despite carrier listings

NPPES Registry: Active NPI, registered in AURORA

Colorado DORA License: License status: Active

PECOS Enrollment: Medicare enrollment confirmed

Federal Exclusion Check: No federal exclusions found (OIG LEIE, SAM.gov)

Carrier Networks: Listed in 6 carrier networks

CMS Care Compare: Not found in CMS Care Compare

Trust Evaluation

identity:0.75Strong

licensure:0.90Strong

activity:

Dimension Scores

Composite0.71

Identity0.75 — Moderate

Active NPI with specialty classification

Licensure0.90 — Strong

Active Colorado DORA license confirmed

Activity0.40 — Weak

No Medicare billing · No electronic endpoint

Reachability0.60 — Moderate

Single address source (NPPES)

Network1.00 — Strong

Listed in multiple carrier networks

Why is this provider classified as “needs review”?

Evidence across dimensions is contradictory or specific concerns exist (unverified license, FHIR directory contradiction). Manual review recommended.

Carrier Network Listings

6 networks across 2 carriers

UnitedHealthcare(5 networks)

1 DOI 6C-34 Federal TiC

UnitedHealthcare of ColoradoDOI 6C-3

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UnitedHealthcare InsuranceFederal TiC

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UnitedHealthcare ServicesFederal TiC

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UnitedHealthcare UMRFederal TiC

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UnitedHealthcare SurestFederal TiC

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Kaiser Permanente

Related Investigations

All providers in UnitedHealthcare of Colorado networkView →All Emergency Medicine providers statewideView →All providers in AURORA 80014View →All providers classified as Needs ReviewView →

Known Addresses

NPPESAURORA, 80014

Evidence

68 items across 21 assertions from 10 sources

Connected Records

Practice Address

AURORA, 80014

NPPES

Colorado License

Active

DORA

Carrier Network Listing

Listed in 6 carrier networks

TiC: UnitedHealthcare Services, TiC: UnitedHealthcare Insurance, TiC: UnitedHealthcare (UMR), TiC: UnitedHealthcare Colorado, TiC: UnitedHealthcare (Surest), TiC: Kaiser Permanente

NPI Registration

Status: active

NPPES Deactivation

Medicare Enrollment

Enrolled

PECOS

entity_type

Record found

NPPES

Federal Exclusion Check

No exclusion found

OIG LEIE + SAM.gov

Evidence Lineage

Colorado License StatusTrust: 0.95

↓DORA5 records ·weight 0.98 · Latest: Mar 6, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORA3 records ·weight 0.60 · Latest: Mar 13, 2026

Matched via: primary

Colorado License StatusTrust: 0.95

↓DORA

Timeline

Mar 13, 2026DORA license check: Active

Mar 13, 2026DORA license check: Expired

Mar 13, 2026DORA license check: Cancelled

Mar 12, 2026Carrier listing: UnitedHealthcare Services

Mar 12, 2026Carrier listing: UnitedHealthcare Insurance

Mar 12, 2026NPPES record: active

Mar 12, 2026Carrier listing: UnitedHealthcare (UMR)

Mar 12, 2026Carrier listing: UnitedHealthcare Colorado

Mar 11, 2026Carrier listing: UnitedHealthcare (Surest)

Mar 11, 2026Medicare enrollment: Approved

Mar 5, 2026

Evidence

Loading evidence lineage...

Disclaimer: This analysis uses publicly available federal and state data sources. It does not constitute a determination of provider status or network participation. Contact the provider or health plan directly to verify current status.

reachability:0.60Moderate

System Determination

Needs Review

Composite score: 0.708

Evidence across dimensions is contradictory — supporting and opposing signals are present.

Kaiser PermanenteDOI 6C-3

View carrier →

Evidence

68 items across 21 assertions from 10 sources

Connected Records

Practice Address

AURORA, 80014

NPPES

Colorado License

Active

DORA

Carrier Network Listing

Listed in 6 carrier networks

TiC: UnitedHealthcare Services, TiC: UnitedHealthcare Insurance, TiC: UnitedHealthcare (UMR), TiC: UnitedHealthcare Colorado, TiC: UnitedHealthcare (Surest), TiC: Kaiser Permanente

NPI Registration

Status: active

NPPES Deactivation

Medicare Enrollment

Enrolled

PECOS

entity_type

Record found

NPPES

Federal Exclusion Check

No exclusion found

OIG LEIE + SAM.gov

Evidence Lineage

Colorado License StatusTrust: 0.95

↓DORA5 records ·weight 0.98 · Latest: Mar 6, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORA3 records ·weight 0.60 · Latest: Mar 13, 2026

Matched via: primary

Colorado License StatusTrust: 0.95

↓DORA

Timeline

Mar 13, 2026DORA license check: Active

Mar 13, 2026DORA license check: Expired

Mar 13, 2026DORA license check: Cancelled

Mar 12, 2026Carrier listing: UnitedHealthcare Services

Mar 12, 2026Carrier listing: UnitedHealthcare Insurance

Mar 12, 2026NPPES record: active

Mar 12, 2026Carrier listing: UnitedHealthcare (UMR)

Mar 12, 2026Carrier listing: UnitedHealthcare Colorado

Mar 11, 2026Carrier listing: UnitedHealthcare (Surest)

Mar 11, 2026Medicare enrollment: Approved

Mar 5, 2026

weight 0.98 · Latest: Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Services9 records ·weight 0.80 · Latest: Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Insurance4 records ·weight 0.80 · Latest: Mar 12, 2026

NPI Registration StatusTrust: 0.90

↓NPPES Deactivationweight 0.85 · Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare (UMR)17 records ·weight 0.80 · Latest: Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Colorado2 records ·weight 0.80 · Latest: Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare (Surest)3 records ·weight 0.80 · Latest: Mar 11, 2026

Medicare EnrollmentTrust: 0.95

↓PECOSweight 0.95 · Mar 11, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Kaiser Permanenteweight 0.80 · Mar 5, 2026

entity_typeTrust: 0.85

↓NPPESweight 0.85 · Mar 5, 2026

Practice LocationTrust: 0.85

↓NPPESweight 0.85 · Mar 5, 2026

Provider SpecialtyTrust: 0.85

↓NPPESweight 0.85 · Mar 5, 2026

Carrier listing: Kaiser Permanente

Mar 5, 2026entity_type: record found

Mar 5, 2026Practice address: AURORA, 80014

Mar 5, 2026Provider Specialty: record found