NPI 1508912197 · Physician · Anthem
Strong multi-source corroboration of active practice across 9 carrier networks with confirmed Colorado DORA license.
NPPES
BOULDER, 80309
Freshness: Unknown
Network Status
Listed with 10 carriers
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)
Listed in multiple carrier networks
9 networks across 4 carriers
Strong network presence across 9 carrier networks with corroborating federal activity signals.
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.