NPI 1649466822 · Physician Assistant · Anthem
Strong multi-source corroboration of active practice across 4 carrier networks with confirmed Colorado DORA license.
NPPES
BOULDER, 80304
Freshness: Unknown
Network Status
Listed with 5 carriers
DORA License
Active
Medicare
275 services
232 beneficiaries
$23,205.74 total payment
Specialty: Physician Assistant
Care Compare
No Care Compare data
PECOS Enrollment
Medicare enrolled
Order/Referring eligible: Yes
Active NPI with specialty classification
Active Colorado DORA license confirmed
Active Medicare billing confirmed
Single address source (NPPES)
Listed in multiple carrier networks
4 networks across 3 carriers
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.