NPI 1063960490 · Physician Assistant · Anthem
Moderate evidence supports active practice with 7 carrier network listings and verified licensure.
NPPES
ENGLEWOOD, 80113
Freshness: Unknown
Network Status
Listed with 7 carriers
DORA License
Active
Medicare
Enrolled but no billing activity
Care Compare
No Care Compare data
PECOS Enrollment
Medicare enrolled
Order/Referring eligible: Yes
Active NPI with specialty classification
Active Colorado DORA license confirmed
No Medicare billing · No electronic endpoint
Single address source (NPPES)
Listed in multiple carrier networks
7 networks across 3 carriers
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.