KEN MACINTYRE

NPI 1740441419 · Psychiatry · Anthem

Provider Status Assessment

Needs Review

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

Confidence: High

Evidence: 144 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

DENVER, 80222

Freshness: Unknown

✓

Network Status

Listed with 7 carriers

anthem_co — in_network (commercial)
anthem_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

329 services

56 beneficiaries

$22,693.61 total payment

Specialty: Psychiatry

✓

Care Compare

Address matches NPPES

DENVER, 80222

✓

PECOS Enrollment

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 DENVER

Medicare Billing: 329 services, 56 beneficiaries

PECOS Enrollment: Medicare enrollment confirmed

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

Carrier Networks: Listed in 7 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 4 carriers

Anthem(1 network)

1 DOI 6C-3

Anthem Blue Cross Blue ShieldDOI 6C-3

View carrier →

UnitedHealthcare(2 networks)

2 Federal TiC

UnitedHealthcare UMRFederal TiC

View carrier →

UnitedHealthcare SurestFederal TiC

View carrier →

Cigna(1 network)

1 DOI 6C-3

Related Investigations

All providers in Anthem Blue Cross Blue Shield networkView →All Psychiatry providers statewideView →All providers in DENVER 80222View →All providers classified as Needs ReviewView →

Known Addresses

NPPESDENVER, 80222

Care CompareDENVER, 80222

Evidence

144 items across 14 assertions from 12 sources

Connected Records

Practice Address

DENVER, 80222

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: Cigna, TiC: Kaiser Permanente Insurance Company, TiC: Kaiser Permanente

NPI Registration

Status: active

NPPES Deactivation

Order/Referring Eligibility

Record found

cms_order_refer

Medicare Enrollment

Enrolled

PECOS

Medicare Billing

329 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 Shield108 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shieldweight 0.80 · Mar 14, 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 (Surest)3 records ·

Timeline

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

Mar 12, 2026NPPES record: active

Mar 12, 2026Carrier listing: UnitedHealthcare (UMR)

Mar 11, 2026Carrier listing: UnitedHealthcare (Surest)

Mar 11, 2026Order/Referring Eligibility: record found

Mar 11, 2026Carrier listing: Cigna

Mar 11, 2026Medicare enrollment: Approved

Mar 11, 2026Carrier listing: Kaiser Permanente Insurance Company

Mar 6, 2026Practice address: DENVER, 80222

Mar 6, 2026Medicare billing: 329 services

Mar 5, 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

144 items across 14 assertions from 12 sources

Connected Records

Practice Address

DENVER, 80222

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: Cigna, TiC: Kaiser Permanente Insurance Company, TiC: Kaiser Permanente

NPI Registration

Status: active

NPPES Deactivation

Order/Referring Eligibility

Record found

cms_order_refer

Medicare Enrollment

Enrolled

PECOS

Medicare Billing

329 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 Shield108 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shieldweight 0.80 · Mar 14, 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 (Surest)3 records ·

Timeline

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

Mar 12, 2026NPPES record: active

Mar 12, 2026Carrier listing: UnitedHealthcare (UMR)

Mar 11, 2026Carrier listing: UnitedHealthcare (Surest)

Mar 11, 2026Order/Referring Eligibility: record found

Mar 11, 2026Carrier listing: Cigna

Mar 11, 2026Medicare enrollment: Approved

Mar 11, 2026Carrier listing: Kaiser Permanente Insurance Company

Mar 6, 2026Practice address: DENVER, 80222

Mar 6, 2026Medicare billing: 329 services

Mar 5, 2026