NPI 1215638796 · Physician · Kaiser
Moderate evidence supports active practice with 1 carrier network listing and verified licensure.
NPPES
BOULDER, 80302
Freshness: Unknown
Network Status
Listed with 1 carrier
DORA License
Active
Medicare
Not enrolled in Medicare (PECOS)
Care Compare
No Care Compare data
PECOS Enrollment
No PECOS data
Active NPI with specialty classification
Active Colorado DORA license confirmed
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.