MARYANN SUDMEIER

NPI 1336212125 · Nurse Practitioner · Anthem

Provider Status Assessment

Needs Review

Active in carrier directories but no matching Colorado DORA license record found.

Confidence: High

Evidence: 5314 items from 16 sources

Signals: 6 supporting · 0 opposing · 1 missing

Resolution: Carrier-attested activity present but no matching Colorado DORA license found. Cannot verify licensing despite network participation.

Data Source Signals

✓

NPPES

GREENWOOD VILLAGE, 80111

Freshness: Unknown

✓

Network Status

Listed with 9 carriers

anthem_co — in_network (commercial)
uhc_colorado_co — in_network (commercial)
uhc_insurance_co — in_network (commercial)
uhc_services_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

No license data

✓

Medicare

15 services

15 beneficiaries

$1,072.26 total payment

Specialty: Nurse Practitioner

✗

Care Compare

Address mismatch with NPPES

GREENWOOD VILLAGE, 80111
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 GREENWOOD VILLAGE

Medicare Billing: 15 services, 15 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 2 locations

Colorado DORA License: No matching DORA license record found

Trust Evaluation

identity:0.75Strong

licensure:0.55Moderate

activity:

Dimension Scores

Composite0.79

Identity0.75 — Moderate

Active NPI with specialty classification

Licensure0.55 — Moderate

No DORA license data found

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 “needs review”?

Evidence across dimensions is contradictory or specific concerns exist (unverified license, FHIR directory contradiction). Manual review recommended.

Carrier Network Listings

9 networks across 4 carriers

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 of ColoradoDOI 6C-3

View carrier →

UnitedHealthcare InsuranceFederal TiC

View carrier →

UnitedHealthcare ServicesFederal TiC

View carrier →

Related Investigations

All providers in Anthem Blue Cross Blue Shield networkView →All Nurse Practitioner providers statewideView →All providers in GREENWOOD VILLAGE 80111View →All providers classified as Needs ReviewView →

Known Addresses

NPPESGREENWOOD VILLAGE, 80111

Care CompareGREENWOOD VILLAGE, 80111

Care CompareWHEAT RIDGE, 80033

Evidence

5314 items across 18 assertions from 16 sources

Connected Records

Practice Address

GREENWOOD VILLAGE, 80111

NPPES, cms_care_compare

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

Open Payments

Record found

cms_open_payments

Order/Referring Eligibility

Record found

cms_order_refer

Medicare Enrollment

Enrolled

PECOS

Medicare Billing

15 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 Shield5262 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Services7 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)

Timeline

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

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, 2026Practice address: GREENWOOD VILLAGE, 80111

Mar 11, 2026Open Payments: record found

Mar 11, 2026Order/Referring Eligibility: record found

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

Order/Referring eligible: Yes

reachability:0.60Moderate

System Determination

Needs Review

Composite score: 0.787

Active in carrier directories but no matching Colorado DORA license record found.

UnitedHealthcare UMR

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

5314 items across 18 assertions from 16 sources

Connected Records

Practice Address

GREENWOOD VILLAGE, 80111

NPPES, cms_care_compare

Carrier Network Listing

Listed in 9 carrier networks

NPI Registration

Status: active

NPPES Deactivation

Open Payments

Record found

cms_open_payments

Order/Referring Eligibility

Record found

cms_order_refer

Medicare Enrollment

Enrolled

PECOS

Medicare Billing

15 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 Shield5262 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Services7 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)

Timeline

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

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, 2026Practice address: GREENWOOD VILLAGE, 80111

Mar 11, 2026Open Payments: record found

Mar 11, 2026Order/Referring Eligibility: record found

Mar 11, 2026

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

Practice LocationTrust: 0.80

↓NPPES2 records ·weight 0.85 · Latest: Mar 11, 2026

↓cms_care_compareweight 0.80 · Mar 6, 2026

Open PaymentsTrust: 0.90

↓cms_open_paymentsweight 0.90 · 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

Carrier Network ListingTrust: 0.80

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

Practice LocationTrust: 0.85

↓cms_care_compareweight 0.80 · Mar 6, 2026

↓NPPESweight 0.85 · Mar 5, 2026

Medicare Billing ActivityTrust: 0.90

↓cms_medicareweight 0.70 · Mar 6, 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

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: GREENWOOD VILLAGE, 80111

Mar 6, 2026Medicare billing: 15 services

Mar 5, 2026Carrier listing: Kaiser Permanente

Mar 5, 2026Practice address: WHEAT RIDGE, 80033

Mar 5, 2026entity_type: record found

Mar 5, 2026Provider Specialty: record found