DEBRA EDELSON

NPI 1952417057 · Psychiatry · Anthem

Provider Status Assessment

Verified Active

Strong multi-source corroboration of active practice across 4 carrier networks with confirmed Colorado DORA license.

Confidence: High

Evidence: 141 items from 11 sources

Signals: 7 supporting · 0 opposing

Resolution: All evidence sources corroborate active practice. 7 supporting signals with no contradictions across 8 evaluated sources.

Data Source Signals

✓

NPPES

BOULDER, 80304

Freshness: Unknown

✓

Network Status

Listed with 5 carriers

anthem_co — in_network (commercial)
anthem_co — in_network (commercial)
uhc_umr_co — in_network (commercial)
uhc_surest_co — in_network (commercial)
kaiser_co — in_network (commercial)

✓

DORA License

Active

✓

Medicare

370 services

66 beneficiaries

$21,610.57 total payment

Specialty: Psychiatry

✓

Care Compare

Address matches NPPES

BOULDER, 80304

✓

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 BOULDER

Colorado DORA License: License status: Active

Medicare Billing: 370 services, 66 beneficiaries

PECOS Enrollment: Medicare enrollment confirmed

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

Carrier Networks: Listed in 5 carrier networks

CMS Care Compare: Found in Care Compare with 1 location

Trust Evaluation

identity:0.75Strong

licensure:0.90Strong

activity:1.00

Dimension Scores

Composite0.84

Identity0.75 — Moderate

Active NPI with specialty classification

Licensure0.90 — Strong

Active Colorado DORA license confirmed

Activity1.00 — Strong

Active Medicare billing confirmed

Reachability0.60 — Moderate

Single address source (NPPES)

Network0.90 — Strong

Listed in multiple carrier networks

Why is this provider classified as “verified active”?

Strong multi-source corroboration of active practice. All dimensions above 0.55 with evidence depth ≥ 5. Active license confirmed.

Carrier Network Listings

4 networks across 3 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 →

Kaiser Permanente(1 network)

1 DOI 6C-3

Related Investigations

All providers in Anthem Blue Cross Blue Shield networkView →All Psychiatry providers statewideView →All providers in BOULDER 80304View →All providers classified as Verified ActiveView →

Known Addresses

NPPESBOULDER, 80304

Care CompareBOULDER, 80304

Evidence

141 items across 14 assertions from 11 sources

Connected Records

Colorado License

Expired

DORA

Practice Address

BOULDER, 80304

cms_care_compare, NPPES

Carrier Network Listing

Listed in 4 carrier networks

TiC: Anthem Blue Cross Blue Shield, TiC: UnitedHealthcare (UMR), TiC: UnitedHealthcare (Surest), TiC: Kaiser Permanente

NPI Registration

Status: active

NPPES Deactivation

Order/Referring Eligibility

Record found

cms_order_refer

Medicare Enrollment

Enrolled

PECOS

Medicare Billing

370 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 Shield104 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shieldweight 0.80 · Mar 14, 2026

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORA6 records ·weight 0.98 · Latest: Mar 6, 2026

Matched via: license_number

NPI Registration StatusTrust: 0.90

↓NPPES Deactivation

Timeline

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

Mar 13, 2026DORA license check: Expired

Mar 13, 2026DORA license check: Active

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, 2026Medicare enrollment: Approved

Mar 6, 2026Practice address: BOULDER, 80304

Mar 6, 2026Medicare billing: 370 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

141 items across 14 assertions from 11 sources

Connected Records

Colorado License

Expired

DORA

Practice Address

BOULDER, 80304

cms_care_compare, NPPES

Carrier Network Listing

Listed in 4 carrier networks

TiC: Anthem Blue Cross Blue Shield, TiC: UnitedHealthcare (UMR), TiC: UnitedHealthcare (Surest), TiC: Kaiser Permanente

NPI Registration

Status: active

NPPES Deactivation

Order/Referring Eligibility

Record found

cms_order_refer

Medicare Enrollment

Enrolled

PECOS

Medicare Billing

370 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 Shield104 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shieldweight 0.80 · Mar 14, 2026

Colorado License StatusTrust: 0.95

↓DORAweight 0.98 · Mar 13, 2026

Matched via: license_number

Colorado License StatusTrust: 0.95

↓DORA6 records ·weight 0.98 · Latest: Mar 6, 2026

Matched via: license_number

NPI Registration StatusTrust: 0.90

↓NPPES Deactivation

Timeline

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

Mar 13, 2026DORA license check: Expired

Mar 13, 2026DORA license check: Active

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, 2026Medicare enrollment: Approved

Mar 6, 2026Practice address: BOULDER, 80304

Mar 6, 2026Medicare billing: 370 services

Mar 5, 2026