PAUL BAILEY

NPI 1225567365 · Physical Therapist in Private Practice · Anthem

Provider Status Assessment

Verified Active

Strong multi-source corroboration of active practice across 9 carrier networks with confirmed Colorado DORA license.

Confidence: High

Evidence: 5723 items from 15 sources

Signals: 7 supporting · 0 opposing

Resolution: All evidence sources corroborate active practice. 7 supporting signals with no contradictions across 8 evaluated sources.

Data Source Signals

✓

NPPES

ENGLEWOOD, 80110

Freshness: Unknown

✓

Network Status

Listed with 9 carriers

anthem_co — in_network (commercial)
uhc_services_co — in_network (commercial)
uhc_colorado_co — in_network (commercial)
uhc_insurance_co — in_network (commercial)
uhc_umr_co — in_network (commercial)
uhc_surest_co — in_network (commercial)
cigna_co — in_network (commercial)
kpic_co — in_network (commercial)
kaiser_co — in_network (commercial)

✓

DORA License

Active

—

Medicare

Non-Medicare specialty

61 beneficiaries

$21,935.64 total payment

Specialty: Physical Therapist in Private Practice

✗

Care Compare

Address mismatch with NPPES

BROOMFIELD, 80021
FIRESTONE, 80504
WHEAT RIDGE, 80033

System Reasoning

Claim Under Evaluation

Provider is actively practicing and appropriately listed in carrier networks

Evidence Evaluated

FHIR Directory: No active FHIR endpoint despite carrier listings

NPPES Registry: Active NPI, registered in ENGLEWOOD

Colorado DORA License: License status: Active

Medicare Billing: 1,047 services, 61 beneficiaries

PECOS Enrollment: Medicare enrollment confirmed

Federal Exclusion Check: No federal exclusions found (OIG LEIE, SAM.gov)

Carrier Networks: Listed in 9 carrier networks

CMS Care Compare: Found in Care Compare with 3 locations

Trust Evaluation

identity:0.75Strong

licensure:0.90Strong

activity:

Dimension Scores

Composite0.86

Identity0.75 — Moderate

Active NPI with specialty classification

Licensure0.90 — Strong

Active Colorado DORA license confirmed

Activity1.00 — Strong

Active Medicare billing confirmed

Reachability0.60 — Moderate

Single address source (NPPES)

Network1.00 — Strong

Listed in multiple carrier networks

Why is this provider classified as “verified active”?

Strong multi-source corroboration of active practice. All dimensions above 0.55 with evidence depth ≥ 5. Active license confirmed.

Carrier Network Listings

9 networks across 4 carriers

Strong network presence across 9 carrier networks with corroborating federal activity signals.

Anthem(1 network)

1 DOI 6C-3

Anthem Blue Cross Blue ShieldDOI 6C-3

View carrier →

UnitedHealthcare(5 networks)

1 DOI 6C-34 Federal TiC

UnitedHealthcare ServicesFederal TiC

View carrier →

UnitedHealthcare of ColoradoDOI 6C-3

View carrier →

UnitedHealthcare InsuranceFederal TiC

View carrier →

Related Investigations

All providers in Anthem Blue Cross Blue Shield networkView →All Physical Therapist in Private Practice providers statewideView →All providers in ENGLEWOOD 80110View →All providers classified as Verified ActiveView →

Known Addresses

NPPESENGLEWOOD, 80110

Care CompareBROOMFIELD, 80021

Care CompareFIRESTONE, 80504

Care CompareWHEAT RIDGE, 80033

Evidence

5723 items across 30 assertions from 15 sources

Connected Records

Colorado License

Expired

DORA

Practice Address

WHEAT RIDGE, 80033

cms_care_compare, NPPES

Carrier Network Listing

Listed in 9 carrier networks

TiC: Anthem Blue Cross Blue Shield, TiC: UnitedHealthcare Services, TiC: UnitedHealthcare Insurance, TiC: UnitedHealthcare (UMR), TiC: UnitedHealthcare Colorado, TiC: UnitedHealthcare (Surest), TiC: Cigna, TiC: Kaiser Permanente Insurance Company, TiC: Kaiser Permanente

NPI Registration

Status: active

NPPES Deactivation

Medicare Enrollment

Enrolled

PECOS

Medicare Billing

1,047 services

cms_medicare

entity_type

Record found

NPPES

Federal Exclusion Check

No exclusion found

OIG LEIE + SAM.gov

Evidence Lineage

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shield5642 records ·weight 0.80 · Latest: Mar 14, 2026

Colorado License StatusTrust: 0.95

↓DORA14 records ·weight 0.98 · Latest: Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORA4 records ·weight 0.98 · Latest: Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓

Timeline

Mar 14, 2026Carrier listing: Anthem Blue Cross Blue Shield

Mar 13, 2026DORA license check: Expired

Mar 13, 2026DORA license check: Active

Mar 13, 2026DORA license check: Inactive

Mar 12, 2026Carrier listing: UnitedHealthcare Services

Mar 12, 2026Carrier listing: UnitedHealthcare Insurance

Mar 12, 2026NPPES record: active

Mar 12, 2026Carrier listing: UnitedHealthcare (UMR)

Mar 12, 2026Carrier listing: UnitedHealthcare Colorado

Mar 11, 2026Carrier listing: UnitedHealthcare (Surest)

Mar 11, 2026

Evidence

Loading evidence lineage...

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.

✓

PECOS Enrollment

Medicare enrolled

reachability:0.60Moderate

System Determination

Verified Active

Composite score: 0.858

Strong multi-source corroboration of active practice across 9 carrier networks with confirmed Colorado DORA license.

UnitedHealthcare UMRFederal TiC

View carrier →

UnitedHealthcare SurestFederal TiC

View carrier →

Cigna(1 network)

1 DOI 6C-3

CignaDOI 6C-3

View carrier →

Kaiser Permanente(2 networks)

2 DOI 6C-3

Kaiser Permanente Insurance CoDOI 6C-3

View carrier →

Kaiser PermanenteDOI 6C-3

View carrier →

Evidence

5723 items across 30 assertions from 15 sources

Connected Records

Colorado License

Expired

DORA

Practice Address

WHEAT RIDGE, 80033

cms_care_compare, NPPES

Carrier Network Listing

Listed in 9 carrier networks

NPI Registration

Status: active

NPPES Deactivation

Medicare Enrollment

Enrolled

PECOS

Medicare Billing

1,047 services

cms_medicare

entity_type

Record found

NPPES

Federal Exclusion Check

No exclusion found

OIG LEIE + SAM.gov

Evidence Lineage

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shield5642 records ·weight 0.80 · Latest: Mar 14, 2026

Colorado License StatusTrust: 0.95

↓DORA14 records ·weight 0.98 · Latest: Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORA4 records ·weight 0.98 · Latest: Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓

Timeline

Mar 14, 2026Carrier listing: Anthem Blue Cross Blue Shield

Mar 13, 2026DORA license check: Expired

Mar 13, 2026DORA license check: Active

Mar 13, 2026DORA license check: Inactive

Mar 12, 2026Carrier listing: UnitedHealthcare Services

Mar 12, 2026Carrier listing: UnitedHealthcare Insurance

Mar 12, 2026NPPES record: active

Mar 12, 2026Carrier listing: UnitedHealthcare (UMR)

Mar 12, 2026Carrier listing: UnitedHealthcare Colorado

Mar 11, 2026Carrier listing: UnitedHealthcare (Surest)

Mar 11, 2026

weight 0.60 · Latest: Mar 13, 2026

Matched via: primary

Colorado License StatusTrust: 0.95

↓DORA3 records ·weight 0.60 · Latest: Mar 13, 2026

Matched via: primary

Colorado License StatusTrust: 0.95

↓DORA3 records ·weight 0.60 · Latest: Mar 13, 2026

Matched via: primary

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Services5 records ·weight 0.80 · Latest: Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Insurance4 records ·weight 0.80 · Latest: Mar 12, 2026

NPI Registration StatusTrust: 0.90

↓NPPES Deactivationweight 0.85 · Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare (UMR)17 records ·weight 0.80 · Latest: Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Colorado2 records ·weight 0.80 · Latest: Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare (Surest)3 records ·weight 0.80 · Latest: Mar 11, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Cigna5 records ·weight 0.80 · Latest: Mar 11, 2026

Medicare EnrollmentTrust: 0.95

↓PECOSweight 0.95 · Mar 11, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Kaiser Permanente Insurance Companyweight 0.80 · Mar 11, 2026

Practice LocationTrust: 0.80

↓cms_care_compareweight 0.80 · Mar 6, 2026

Practice LocationTrust: 0.80

↓cms_care_compareweight 0.80 · Mar 6, 2026

Practice LocationTrust: 0.80

↓cms_care_compareweight 0.80 · Mar 6, 2026

Medicare Billing ActivityTrust: 0.90

↓cms_medicareweight 0.95 · Mar 6, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Kaiser Permanenteweight 0.80 · Mar 5, 2026

Practice LocationTrust: 0.85

↓NPPESweight 0.85 · Mar 5, 2026

entity_typeTrust: 0.85

↓NPPESweight 0.85 · Mar 5, 2026

Provider SpecialtyTrust: 0.85

↓NPPESweight 0.85 · Mar 5, 2026

Carrier listing: Cigna

Mar 11, 2026Medicare enrollment: Approved

Mar 11, 2026Carrier listing: Kaiser Permanente Insurance Company

Mar 6, 2026Practice address: WHEAT RIDGE, 80033

Mar 6, 2026Practice address: BROOMFIELD, 80021

Mar 6, 2026Practice address: FIRESTONE, 80504

Mar 6, 2026Medicare billing: 1,047 services

Mar 5, 2026Carrier listing: Kaiser Permanente

Mar 5, 2026Practice address: ENGLEWOOD, 80110

Mar 5, 2026entity_type: record found

Showing 20 of 21 evidence events.