EMILY BAKER

NPI 1578519633 · Optometry · Uhc Services

Provider Status Assessment

Needs Review

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

Confidence: High

Evidence: 43 items from 12 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

BROOMFIELD, 80021

Freshness: Unknown

✓

Network Status

Listed with 6 carriers

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)
uhc_rmhmo_co — in_network (commercial)

—

DORA License

No license data

—

Medicare

Non-Medicare specialty

43 beneficiaries

$3,605.98 total payment

Specialty: Optometry

✓

Care Compare

Address matches NPPES

BROOMFIELD, 80021

✓

PECOS Enrollment

Medicare enrolled

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 BROOMFIELD

Medicare Billing: 46 services, 43 beneficiaries

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

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

6 networks across 1 carrier

UnitedHealthcare(6 networks)

2 DOI 6C-34 Federal TiC

UnitedHealthcare ServicesFederal TiC

View carrier →

UnitedHealthcare of ColoradoDOI 6C-3

View carrier →

UnitedHealthcare InsuranceFederal TiC

View carrier →

UnitedHealthcare UMRFederal TiC

View carrier →

UnitedHealthcare SurestFederal TiC

View carrier →

UnitedHealthcare Rocky Mountain HMODOI 6C-3

Related Investigations

All providers in UnitedHealthcare Services networkView →All Optometry providers statewideView →All providers in BROOMFIELD 80021View →All providers classified as Needs ReviewView →

Known Addresses

NPPESBROOMFIELD, 80021

Care CompareBROOMFIELD, 80021

Evidence

43 items across 13 assertions from 12 sources

Connected Records

Practice Address

BROOMFIELD, 80021

cms_care_compare, NPPES

Carrier Network Listing

Listed in 6 carrier networks

TiC: UnitedHealthcare Services, TiC: UnitedHealthcare Insurance, TiC: UnitedHealthcare (UMR), TiC: UnitedHealthcare Colorado, TiC: UnitedHealthcare (Surest), TiC: UnitedHealthcare (Rocky Mountain HMO)

NPI Registration

Status: active

NPPES Deactivation

Order/Referring Eligibility

Record found

cms_order_refer

Medicare Enrollment

Enrolled

PECOS

Medicare Billing

46 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: UnitedHealthcare Services7 records ·weight 0.80 · Latest: Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Insurance5 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 ·

Timeline

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, 2026Carrier listing: UnitedHealthcare (Rocky Mountain HMO)

Mar 11, 2026Order/Referring Eligibility: record found

Mar 11, 2026Medicare enrollment: Approved

Mar 6, 2026Practice address: BROOMFIELD, 80021

Mar 6, 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.

Evidence

43 items across 13 assertions from 12 sources

Connected Records

Practice Address

BROOMFIELD, 80021

cms_care_compare, NPPES

Carrier Network Listing

Listed in 6 carrier networks

NPI Registration

Status: active

NPPES Deactivation

Order/Referring Eligibility

Record found

cms_order_refer

Medicare Enrollment

Enrolled

PECOS

Medicare Billing

46 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: UnitedHealthcare Services7 records ·weight 0.80 · Latest: Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Insurance5 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 ·

Timeline

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, 2026Carrier listing: UnitedHealthcare (Rocky Mountain HMO)

Mar 11, 2026Order/Referring Eligibility: record found

Mar 11, 2026Medicare enrollment: Approved

Mar 6, 2026Practice address: BROOMFIELD, 80021

Mar 6, 2026