NPI 1194185298 · Physician Assistant - Certified · Anthem
Active in carrier directories but no matching Colorado DORA license record found.
NPPES
BOULDER, 80302
Freshness: Unknown
Network Status
Listed with 1 carrier
DORA License
No license data
Medicare
Not enrolled in Medicare (PECOS)
Care Compare
No Care Compare data
PECOS Enrollment
No PECOS data
Active NPI with specialty classification
No DORA license data found
No Medicare billing · No electronic endpoint · No PECOS enrollment
Single address source (NPPES)
Weak network corroboration
1 network across 1 carrier
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.