ABIGAIL COOK

NPI 1992235428 · Physician Assistant · Anthem

Provider Status Assessment

Needs Review

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

Confidence: High

Evidence: 9142 items from 15 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, 80204

Freshness: Unknown

✓

Network Status

Listed with 10 carriers

anthem_co — in_network (commercial)
anthem_co — in_network (commercial)
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)
cigna_co — in_network (commercial)
kpic_co — in_network (commercial)
kaiser_co — in_network (commercial)

—

DORA License

No license data

✓

Medicare

21 services

13 beneficiaries

$861.59 total payment

Specialty: Physician Assistant

✗

Care Compare

Address mismatch with NPPES

DENVER, 80202

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: 21 services, 13 beneficiaries

PECOS Enrollment: Medicare enrollment confirmed

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

Carrier Networks: Listed in 10 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

9 networks across 4 carriers

Anthem(1 network)

1 DOI 6C-3

Anthem Blue Cross Blue ShieldDOI 6C-3

View carrier →

UnitedHealthcare(5 networks)

1 DOI 6C-34 Federal TiC

UnitedHealthcare ServicesFederal TiC

View carrier →

UnitedHealthcare of ColoradoDOI 6C-3

View carrier →

UnitedHealthcare InsuranceFederal TiC

View carrier →

Related Investigations

All providers in Anthem Blue Cross Blue Shield networkView →All Physician Assistant providers statewideView →All providers in DENVER 80204View →All providers classified as Needs ReviewView →

Known Addresses

NPPESDENVER, 80204

Care CompareDENVER, 80202

Evidence

9142 items across 18 assertions from 15 sources

Connected Records

Practice Address

DENVER, 80202

cms_care_compare, NPPES

Carrier Network Listing

Listed in 9 carrier networks

TiC: Anthem Blue Cross Blue Shield, TiC: UnitedHealthcare Services, TiC: UnitedHealthcare Insurance, TiC: UnitedHealthcare (UMR), TiC: UnitedHealthcare Colorado, 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

21 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 Shield9084 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shield11 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Services6 records ·weight 0.80 · Latest: Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Insurance4 records ·weight 0.80 · Latest: Mar 12, 2026

NPI Registration StatusTrust: 0.90

↓

Timeline

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

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, 2026Order/Referring Eligibility: record found

Mar 11, 2026Carrier listing: Cigna

Mar 11, 2026Medicare enrollment: Approved

Mar 11, 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

9142 items across 18 assertions from 15 sources

Connected Records

Practice Address

DENVER, 80202

cms_care_compare, NPPES

Carrier Network Listing

Listed in 9 carrier networks

NPI Registration

Status: active

NPPES Deactivation

Order/Referring Eligibility

Record found

cms_order_refer

Medicare Enrollment

Enrolled

PECOS

Medicare Billing

21 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 Shield9084 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shield11 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Services6 records ·weight 0.80 · Latest: Mar 12, 2026

Carrier Network ListingTrust: 0.80

↓TiC: UnitedHealthcare Insurance4 records ·weight 0.80 · Latest: Mar 12, 2026

NPI Registration StatusTrust: 0.90

↓

Timeline

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

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, 2026Order/Referring Eligibility: record found

Mar 11, 2026Carrier listing: Cigna

Mar 11, 2026Medicare enrollment: Approved

Mar 11, 2026