NPI 1770536344 · Physician Assistant · Anthem
Carrier listings present but Colorado DORA license appears expired or revoked.
NPPES
WHEAT RIDGE, 80033
Freshness: Unknown
Network Status
Listed with 6 carriers
DORA License
Expired
Medicare
Not enrolled in Medicare (PECOS)
243 beneficiaries
$22,316.82 total payment
Specialty: Physician Assistant
Care Compare
No Care Compare data
PECOS Enrollment
No PECOS data
Active NPI with specialty classification
DORA license expired or revoked
Active Medicare billing confirmed
Single address source (NPPES)
Listed in multiple carrier networks
6 networks across 2 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.