CLARISA HERNANDEZ-KOOGLE

NPI 1316305147 · Nurse Practitioner · Anthem

Provider Status Assessment

Likely Active

Moderate evidence supports active practice with 6 carrier network listings and verified licensure.

Confidence: High

Evidence: 86 items from 12 sources

Signals: 6 supporting · 0 opposing

Resolution: Moderate evidence supports active practice across 6 sources. No contradictory signals detected.

Data Source Signals

✓

NPPES

PARKER, 80138

Freshness: Unknown

✓

Network Status

Listed with 6 carriers

anthem_co — in_network (commercial)
uhc_umr_co — in_network (commercial)
uhc_surest_co — in_network (commercial)
uhc_rmhmo_co — in_network (commercial)
cigna_co — in_network (commercial)
kaiser_co — in_network (commercial)

✓

DORA License

Active

✗

Medicare

Enrolled but no billing activity

✓

Care Compare

Address matches NPPES

PARKER, 80138

✓

PECOS Enrollment

Medicare enrolled

Order/Referring eligible: Yes

System Reasoning

Claim Under Evaluation

Provider is actively practicing and appropriately listed in carrier networks

Evidence Evaluated

Medicare Billing: Enrolled in Medicare but no recent billing data

FHIR Directory: No active FHIR endpoint despite carrier listings

NPPES Registry: Active NPI, registered in PARKER

Colorado DORA License: License status: Active

PECOS Enrollment: Medicare enrollment confirmed

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

Carrier Networks: Listed in 6 carrier networks

CMS Care Compare: Found in Care Compare with 1 location

Trust Evaluation

identity:0.75Strong

licensure:0.90Strong

activity:

Dimension Scores

Composite0.73

Identity0.75 — Moderate

Active NPI with specialty classification

Licensure0.90 — Strong

Active Colorado DORA license confirmed

Activity0.50 — Moderate

No Medicare billing · No electronic endpoint

Reachability0.60 — Moderate

Single address source (NPPES)

Network1.00 — Strong

Listed in multiple carrier networks

Why is this provider classified as “likely active”?

Moderate evidence supports active practice. All dimensions above 0.40 with evidence depth ≥ 4. Licensure verified.

Carrier Network Listings

6 networks across 4 carriers

Anthem(1 network)

1 DOI 6C-3

Anthem Blue Cross Blue ShieldDOI 6C-3

View carrier →

UnitedHealthcare(3 networks)

1 DOI 6C-32 Federal TiC

UnitedHealthcare UMRFederal TiC

View carrier →

UnitedHealthcare SurestFederal TiC

View carrier →

UnitedHealthcare Rocky Mountain HMODOI 6C-3

View carrier →

Related Investigations

All providers in Anthem Blue Cross Blue Shield networkView →All Nurse Practitioner providers statewideView →All providers in PARKER 80138View →All providers classified as Likely ActiveView →

Known Addresses

NPPESPARKER, 80138

Care ComparePARKER, 80138

Evidence

86 items across 21 assertions from 12 sources

Connected Records

Practice Address

PARKER, 80138

cms_care_compare, NPPES

Carrier Network Listing

Listed in 6 carrier networks

TiC: Anthem Blue Cross Blue Shield, TiC: UnitedHealthcare (UMR), TiC: UnitedHealthcare (Surest), TiC: UnitedHealthcare (Rocky Mountain HMO), TiC: Cigna, TiC: Kaiser Permanente

Colorado License

Active

DORA

NPI Registration

Status: active

NPPES Deactivation

Order/Referring Eligibility

Record found

cms_order_refer

Medicare Enrollment

Enrolled

PECOS

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 Shield10 records ·weight 0.80 · Latest: Mar 14, 2026

Colorado License StatusTrust: 0.95

↓DORA6 records ·weight 0.98 · Latest: Mar 6, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORA4 records ·weight 0.98 · Latest: Mar 6, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORA3 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: Active

Mar 13, 2026DORA license check: Cancelled

Mar 13, 2026DORA license check: Expired

Mar 12, 2026NPPES record: active

Mar 12, 2026Carrier listing: UnitedHealthcare (UMR)

Mar 11, 2026Carrier listing: UnitedHealthcare (Surest)

Mar 11, 2026Carrier listing: UnitedHealthcare (Rocky Mountain HMO)

Mar 11, 2026Order/Referring Eligibility: record found

Mar 11, 2026Carrier listing: Cigna

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.

reachability:0.60Moderate

System Determination

Likely Active

Composite score: 0.733

Moderate evidence supports active practice with 6 carrier network listings and verified licensure.

CignaDOI 6C-3

View carrier →

Kaiser Permanente(1 network)

1 DOI 6C-3

Kaiser PermanenteDOI 6C-3

View carrier →

Evidence

86 items across 21 assertions from 12 sources

Connected Records

Practice Address

PARKER, 80138

cms_care_compare, NPPES

Carrier Network Listing

Listed in 6 carrier networks

TiC: Anthem Blue Cross Blue Shield, TiC: UnitedHealthcare (UMR), TiC: UnitedHealthcare (Surest), TiC: UnitedHealthcare (Rocky Mountain HMO), TiC: Cigna, TiC: Kaiser Permanente

Colorado License

Active

DORA

NPI Registration

Status: active

NPPES Deactivation

Order/Referring Eligibility

Record found

cms_order_refer

Medicare Enrollment

Enrolled

PECOS

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 Shield10 records ·weight 0.80 · Latest: Mar 14, 2026

Colorado License StatusTrust: 0.95

↓DORA6 records ·weight 0.98 · Latest: Mar 6, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORA4 records ·weight 0.98 · Latest: Mar 6, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORA3 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: Active

Mar 13, 2026DORA license check: Cancelled

Mar 13, 2026DORA license check: Expired

Mar 12, 2026NPPES record: active

Mar 12, 2026Carrier listing: UnitedHealthcare (UMR)

Mar 11, 2026Carrier listing: UnitedHealthcare (Surest)

Mar 11, 2026Carrier listing: UnitedHealthcare (Rocky Mountain HMO)

Mar 11, 2026Order/Referring Eligibility: record found

Mar 11, 2026Carrier listing: Cigna

Mar 11, 2026

weight 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

↓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

↓DORA5 records ·weight 0.98 · Latest: Mar 6, 2026

Matched via: license_number

NPI Registration StatusTrust: 0.90

↓NPPES Deactivationweight 0.85 · Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare (UMR)29 records ·weight 0.80 · Latest: Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare (Surest)6 records ·weight 0.80 · Latest: Mar 11, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare (Rocky Mountain HMO)2 records ·weight 0.80 · Latest: Mar 11, 2026

Order/Referring EligibilityTrust: 0.95

↓cms_order_referweight 0.95 · 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

Practice LocationTrust: 0.85

↓cms_care_compareweight 0.80 · Mar 6, 2026

↓NPPESweight 0.85 · Mar 5, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Kaiser Permanenteweight 0.80 · Mar 5, 2026

entity_typeTrust: 0.85

↓NPPESweight 0.85 · Mar 5, 2026

Provider SpecialtyTrust: 0.85

↓NPPESweight 0.85 · Mar 5, 2026

Medicare enrollment: Approved

Mar 6, 2026Practice address: PARKER, 80138

Mar 5, 2026Carrier listing: Kaiser Permanente

Mar 5, 2026Practice address: PARKER, 80138

Mar 5, 2026entity_type: record found

Mar 5, 2026Provider Specialty: record found