NPI 1194886432 · Physician · Kpic
Moderate evidence supports active practice with 2 carrier network listings and verified licensure.
NPPES
BOULDER, 80301
Freshness: Unknown
Network Status
Listed with 2 carriers
DORA License
Active
Medicare
Non-Medicare specialty
Care Compare
No Care Compare data
PECOS Enrollment
Medicare enrolled
Active NPI with specialty classification
Active Colorado DORA license confirmed
No Medicare billing · No electronic endpoint
Single address source (NPPES)
Limited carrier network presence
2 networks 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.