NPI 1104814540 · Physician Assistant · Uhc Services
Strong multi-source corroboration of active practice across 7 carrier networks with confirmed Colorado DORA license.
NPPES
BOULDER, 80304
Freshness: Unknown
Network Status
Listed with 7 carriers
DORA License
Active
Medicare
Enrolled but no billing activity
Care Compare
Address mismatch with NPPES
PECOS Enrollment
Medicare enrolled
Order/Referring eligible: Yes
Active NPI with specialty classification
Active Colorado DORA license confirmed
Active Medicare billing confirmed
Single address source (NPPES)
Listed in multiple carrier networks
7 networks across 2 carriers
Strong network presence across 7 carrier networks with corroborating federal activity signals.
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.