| Clinica Family Health | |
|
1735 S Public Rd Ste 201 Lafayette CO 80026-7093 | |
| (303) 665-3036 | |
| (303) 665-9566 |
| Full Name | Clinica Family Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 1735 S Public Rd Ste 201, Lafayette, Colorado |
| Authorized Official Name and Position | Brian J Johnston (CFO) |
| Authorized Official Contact | 3039260625 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Family Health 1735 S Public Rd Ste 203 Lafayette CO 80026-7093 Ph: (303) 665-3036 | Clinica Family Health 1735 S Public Rd Ste 201 Lafayette CO 80026-7093 Ph: (303) 665-3036 |
| NPI Number | 1225025406 |
|---|---|
| Provider Enumeration Date | 10/03/2005 |
| Last Update Date | 07/13/2022 |
| Medicare PECOS PAC ID | 7315850484 |
|---|---|
| Medicare Enrollment ID | O20031106000276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225025406 | NPI | - | NPPES |
| 04169041 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 0556 (Colorado) | Primary |
| Provider Name | Marion B Mazzola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366474041 PECOS PAC ID: 3173516655 Enrollment ID: I20040408000654 |
| Provider Name | Karen A Funk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447248885 PECOS PAC ID: 8325015688 Enrollment ID: I20040915000727 |
| Provider Name | Marilyn K Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770649634 PECOS PAC ID: 1557303609 Enrollment ID: I20050527000758 |
| Provider Name | Carolyn Muriel Shepherd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538157854 PECOS PAC ID: 4183650443 Enrollment ID: I20050709000062 |
| Provider Name | Jennifer L Scanlon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558446203 PECOS PAC ID: 1254360407 Enrollment ID: I20050808000703 |
| Provider Name | Kevin James Dryden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285731240 PECOS PAC ID: 5597780171 Enrollment ID: I20051012000903 |
| Provider Name | Misae Ueha Vela Brol |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972592657 PECOS PAC ID: 2860414752 Enrollment ID: I20051220000347 |
| Provider Name | Christoph J Keenan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851389209 PECOS PAC ID: 1355344763 Enrollment ID: I20060824000016 |
| Provider Name | Alex D Bulkacz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639167075 PECOS PAC ID: 8527061936 Enrollment ID: I20060824000022 |
| Provider Name | Carol D Siegel Friefeld |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245228576 PECOS PAC ID: 3971506387 Enrollment ID: I20060824000029 |
| Provider Name | Carolyn S Chen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649203332 PECOS PAC ID: 8325046899 Enrollment ID: I20061116000209 |
| Provider Name | Kimberly K Bezdek Benage |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629184429 PECOS PAC ID: 9537175575 Enrollment ID: I20061120000570 |
| Provider Name | Maria T Somerset |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912915018 PECOS PAC ID: 1557393725 Enrollment ID: I20061122000279 |
| Provider Name | Christa Elizabeth Ambrose |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1902912116 PECOS PAC ID: 8729095914 Enrollment ID: I20061221000223 |
| Provider Name | Catherine E Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861573156 PECOS PAC ID: 0143323196 Enrollment ID: I20070312000235 |
| Provider Name | Maria G Bustamante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851389811 PECOS PAC ID: 8820182884 Enrollment ID: I20070920000799 |
| Provider Name | Claire M Coughlan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710176623 PECOS PAC ID: 6002906112 Enrollment ID: I20071213000080 |
| Provider Name | Eric C Boysen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437337201 PECOS PAC ID: 8022188374 Enrollment ID: I20080529000636 |
| Provider Name | Tamara L Willis-buckley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669413126 PECOS PAC ID: 6406840636 Enrollment ID: I20080721000766 |
| Provider Name | Justin Daniel Wheeler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265564009 PECOS PAC ID: 7416022504 Enrollment ID: I20080825000537 |
| Provider Name | Pamela C Guthrie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891837233 PECOS PAC ID: 6709944028 Enrollment ID: I20081015000197 |
| Provider Name | Michelle L Drury |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437240025 PECOS PAC ID: 9931267267 Enrollment ID: I20081015000261 |
| Provider Name | Julie P Hirman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861655250 PECOS PAC ID: 5294893012 Enrollment ID: I20081023000416 |
| Provider Name | Anne K Hansen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669677472 PECOS PAC ID: 5991863540 Enrollment ID: I20081025000129 |
| Provider Name | Joshua Brannon Messer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841346459 PECOS PAC ID: 5496815672 Enrollment ID: I20081118000306 |
| Provider Name | Bessie M Odea |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851376628 PECOS PAC ID: 7810926920 Enrollment ID: I20090327000424 |
| Provider Name | Amy M Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578720314 PECOS PAC ID: 7416008131 Enrollment ID: I20090619000186 |
| Provider Name | Ruth C Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427286954 PECOS PAC ID: 4284780008 Enrollment ID: I20090921000367 |
| Provider Name | Jennifer Blair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053587741 PECOS PAC ID: 0042348955 Enrollment ID: I20100513001141 |
| Provider Name | Zachary C Wachtl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407073976 PECOS PAC ID: 9133313943 Enrollment ID: I20101104001389 |
| Provider Name | Kristin K Andreen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477712529 PECOS PAC ID: 6800080680 Enrollment ID: I20101105000517 |
| Provider Name | Carlos G Vela Brol |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861710956 PECOS PAC ID: 6800076647 Enrollment ID: I20110210000558 |
| Provider Name | Mary L Karner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215925664 PECOS PAC ID: 0941481261 Enrollment ID: I20110221000122 |
| Provider Name | Susan M Jager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134117583 PECOS PAC ID: 6305029349 Enrollment ID: I20110329000192 |
| Provider Name | Susan J Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669460010 PECOS PAC ID: 8022291814 Enrollment ID: I20110401000270 |
| Provider Name | Alison P Shepherd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669779716 PECOS PAC ID: 4082899455 Enrollment ID: I20110428000358 |
| Provider Name | Tamaan K Osbourne Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245424076 PECOS PAC ID: 7214114032 Enrollment ID: I20110603000407 |
| Provider Name | Julie Marie Yung |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891971982 PECOS PAC ID: 2264566942 Enrollment ID: I20110803000950 |
| Provider Name | Rachel A Garza Haukoos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184928426 PECOS PAC ID: 1951574771 Enrollment ID: I20111024000067 |
| Provider Name | Erin Inglis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174645238 PECOS PAC ID: 6901093244 Enrollment ID: I20111130000149 |
| Provider Name | Angela K Fryer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558589390 PECOS PAC ID: 0749473494 Enrollment ID: I20120501000387 |
| Provider Name | Lisa M Winkler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124314638 PECOS PAC ID: 3779748322 Enrollment ID: I20120703000652 |
| Provider Name | Amy L Rinner |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811218506 PECOS PAC ID: 9335390996 Enrollment ID: I20121108000443 |
| Provider Name | Amy E Morin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396061438 PECOS PAC ID: 7012187768 Enrollment ID: I20121109000499 |
| Provider Name | Kaitlin R Prinsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649591330 PECOS PAC ID: 7113171273 Enrollment ID: I20130126000036 |
| Provider Name | Jennifer Gayle Gaide |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881868479 PECOS PAC ID: 9638323041 Enrollment ID: I20130213000212 |
| Provider Name | William A Van Eimeren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447237219 PECOS PAC ID: 6204999329 Enrollment ID: I20130228000112 |
| Provider Name | Devon L Wall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265702377 PECOS PAC ID: 2163672999 Enrollment ID: I20130903000460 |
| Provider Name | Janell L Durnen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265874929 PECOS PAC ID: 8820226095 Enrollment ID: I20140115000303 |
| Provider Name | Jonathan Hutcheson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144500554 PECOS PAC ID: 4587893516 Enrollment ID: I20140214000893 |
| Provider Name | Lauren K Ramnarine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225321268 PECOS PAC ID: 1557592581 Enrollment ID: I20140314001813 |
| Provider Name | Philip Jeffrey Keppeler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972730638 PECOS PAC ID: 3072736479 Enrollment ID: I20140603000129 |
| Provider Name | Carol Susan Lehman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497714158 PECOS PAC ID: 7416171632 Enrollment ID: I20140610000423 |
| Provider Name | Christine Marie Finn |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1235547183 PECOS PAC ID: 4688894157 Enrollment ID: I20141003002035 |
| Provider Name | Jessica J Kenerson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972766335 PECOS PAC ID: 1456523331 Enrollment ID: I20141013001894 |
| Provider Name | Britt K Severson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639433618 PECOS PAC ID: 4183848237 Enrollment ID: I20151005000864 |
| Provider Name | Marja Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124307145 PECOS PAC ID: 4385954114 Enrollment ID: I20151107000026 |
| Provider Name | Jaime N Dibrowa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952726085 PECOS PAC ID: 3870711807 Enrollment ID: I20160217000195 |
| Provider Name | Kelley Leigh Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891069696 PECOS PAC ID: 2860657871 Enrollment ID: I20160217000830 |
| Provider Name | Rachel Lillian Laaff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538575691 PECOS PAC ID: 6901028554 Enrollment ID: I20160218002114 |
| Provider Name | Taylor M Hedlund |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194131300 PECOS PAC ID: 5496056095 Enrollment ID: I20160226000066 |
| Provider Name | Corinne Mary Brock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699078980 PECOS PAC ID: 1850513490 Enrollment ID: I20160311001123 |
| Provider Name | Jennifer Michelle Manchester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063755304 PECOS PAC ID: 4688970973 Enrollment ID: I20160314000186 |
| Provider Name | Rebecca S Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184011884 PECOS PAC ID: 7719296029 Enrollment ID: I20160314001667 |
| Provider Name | Ashley Donia Fredrickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285040345 PECOS PAC ID: 1052533676 Enrollment ID: I20160314002173 |
| Provider Name | Nancy Evelyn Blomgren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669581187 PECOS PAC ID: 2466515432 Enrollment ID: I20160315001059 |
| Provider Name | Erin Atkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730170689 PECOS PAC ID: 4183691603 Enrollment ID: I20160315001156 |
| Provider Name | Ariella Jolly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518331958 PECOS PAC ID: 0042517989 Enrollment ID: I20160321001797 |
| Provider Name | Morgen Villegas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265871404 PECOS PAC ID: 7214234947 Enrollment ID: I20160324000341 |
| Provider Name | Jennifer Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033486725 PECOS PAC ID: 7113183781 Enrollment ID: I20160426000469 |
| Provider Name | Erica L Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174806780 PECOS PAC ID: 7416107990 Enrollment ID: I20160427000259 |
| Provider Name | Dorothea L Erwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497100630 PECOS PAC ID: 2668761990 Enrollment ID: I20160510000915 |
| Provider Name | Michelle Corcoran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316354285 PECOS PAC ID: 8426348657 Enrollment ID: I20160601000113 |
| Provider Name | Layla S. Jaffree |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386919587 PECOS PAC ID: 0446470223 Enrollment ID: I20160803002899 |
| Provider Name | Steven Joseph Sushinsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932548989 PECOS PAC ID: 9739303868 Enrollment ID: I20160816001655 |
| Provider Name | Katherine Starr Wiegert Speckman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427491570 PECOS PAC ID: 7315254026 Enrollment ID: I20160817000572 |
| Provider Name | Jennifer Feng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720321029 PECOS PAC ID: 4688982366 Enrollment ID: I20160825001597 |
| Provider Name | Emily Ann Eichhorn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144575176 PECOS PAC ID: 8628210853 Enrollment ID: I20160922001279 |
| Provider Name | Katherine O Spira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346601754 PECOS PAC ID: 2668760737 Enrollment ID: I20161006000106 |
| Provider Name | Linda Tuzzolino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144625641 PECOS PAC ID: 6608164082 Enrollment ID: I20161018002231 |
| Provider Name | Claudia C Wies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932584042 PECOS PAC ID: 4284942608 Enrollment ID: I20170112002483 |
| Provider Name | Maryem Kianinejad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831638386 PECOS PAC ID: 8729362363 Enrollment ID: I20170228000786 |
| Provider Name | Teal Flanigan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154753358 PECOS PAC ID: 8921376294 Enrollment ID: I20170612000426 |
| Provider Name | Rachel Shannon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194146902 PECOS PAC ID: 6305114273 Enrollment ID: I20170617000013 |
| Provider Name | Kari Baars |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033442009 PECOS PAC ID: 5890063713 Enrollment ID: I20170619001795 |
| Provider Name | Abigail L Nass |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487951794 PECOS PAC ID: 5193093797 Enrollment ID: I20170623001037 |
| Provider Name | Michael M Dow |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427151224 PECOS PAC ID: 9537438346 Enrollment ID: I20170711002542 |
| Provider Name | Breanna Tomlin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265878631 PECOS PAC ID: 3870721954 Enrollment ID: I20170808002976 |
| Provider Name | Eric Mcniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285152264 PECOS PAC ID: 5395019681 Enrollment ID: I20170926001236 |
| Provider Name | Hayley Marcus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528487774 PECOS PAC ID: 8325269558 Enrollment ID: I20171009000189 |
| Provider Name | Shivaun Finn Hoyl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568882520 PECOS PAC ID: 8628343183 Enrollment ID: I20171009003181 |
| Provider Name | Benjamin J Huntley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740574144 PECOS PAC ID: 4587890637 Enrollment ID: I20171011002987 |
| Provider Name | Sharon Bates Kirby |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639599178 PECOS PAC ID: 2062705254 Enrollment ID: I20171025000010 |
| Provider Name | Erin S Huntley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154610194 PECOS PAC ID: 6103126875 Enrollment ID: I20171122000433 |
| Provider Name | Emily Gutgsell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760801013 PECOS PAC ID: 3870719016 Enrollment ID: I20171129003367 |
| Provider Name | Rebekka Zak |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1427493600 PECOS PAC ID: 6507170396 Enrollment ID: I20180517000811 |
| Provider Name | Amber Ivanova |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063917862 PECOS PAC ID: 3173878469 Enrollment ID: I20180608000503 |
| Provider Name | Upasana B. Mohapatra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457764367 PECOS PAC ID: 3971827312 Enrollment ID: I20180608000806 |
| Provider Name | Megan Marie Adamson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518125715 PECOS PAC ID: 1850569005 Enrollment ID: I20180613001718 |
| Provider Name | Ruchi Mathur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558740175 PECOS PAC ID: 8820342652 Enrollment ID: I20181114002920 |
| Provider Name | Hollyanne Giffin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831570217 PECOS PAC ID: 5991042558 Enrollment ID: I20190122000647 |
| Provider Name | Makenzie Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003293408 PECOS PAC ID: 3779883178 Enrollment ID: I20190205003091 |
| Provider Name | Megan E Carlberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922493543 PECOS PAC ID: 1456628692 Enrollment ID: I20190213000287 |
| Provider Name | Daisy Fitzgerald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689071540 PECOS PAC ID: 0749520369 Enrollment ID: I20190319000648 |
| Provider Name | Jennifer Berngard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275897241 PECOS PAC ID: 3577788553 Enrollment ID: I20190404002165 |
| Provider Name | Sarah Daily-sheilds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962802728 PECOS PAC ID: 0648512541 Enrollment ID: I20190424002415 |
| Provider Name | Jordan Gerard Levandoski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609333871 PECOS PAC ID: 3476887894 Enrollment ID: I20190618003430 |
| Provider Name | Ciani Kate Sosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265907406 PECOS PAC ID: 5799019139 Enrollment ID: I20190619000695 |
| Provider Name | Richard Ramsey |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1962592121 PECOS PAC ID: 9133428303 Enrollment ID: I20190820003307 |
| Provider Name | Stephanie Ching Wong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962050591 PECOS PAC ID: 7315379658 Enrollment ID: I20191107001482 |
| Provider Name | Megan Frances Foster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366946964 PECOS PAC ID: 4688006851 Enrollment ID: I20191111000735 |
| Provider Name | Edith Helena Presler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629628177 PECOS PAC ID: 5193157139 Enrollment ID: I20191113002850 |
| Provider Name | Anne-laure Shelton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033552757 PECOS PAC ID: 5395037030 Enrollment ID: I20191114002961 |
| Provider Name | Terra H Share |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386041044 PECOS PAC ID: 0042642415 Enrollment ID: I20191125000067 |
| Provider Name | Janira Gonzalez-cunningham |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699098129 PECOS PAC ID: 5890063952 Enrollment ID: I20191218000701 |
| Provider Name | Diane Asher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003286303 PECOS PAC ID: 8527377993 Enrollment ID: I20200115000041 |
| Provider Name | Alison Alter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528534211 PECOS PAC ID: 4082049275 Enrollment ID: I20200116000682 |
| Provider Name | Juliana Flora Vergaray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447569769 PECOS PAC ID: 4880029941 Enrollment ID: I20200117000738 |
| Provider Name | Alison Van Voorhees Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356990691 PECOS PAC ID: 3375972854 Enrollment ID: I20200403002098 |
| Provider Name | Madeline Cole |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942688015 PECOS PAC ID: 5597065292 Enrollment ID: I20200708003750 |
| Provider Name | Alice M Tariot |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629080718 PECOS PAC ID: 5597723148 Enrollment ID: I20201221000145 |
| Provider Name | Genaro Alberto Laynes Odiaga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447854708 PECOS PAC ID: 2365858941 Enrollment ID: I20210305000201 |
| Provider Name | Mackenzie Kigin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457700908 PECOS PAC ID: 0840528501 Enrollment ID: I20210324000137 |
| Provider Name | Carolyn Dinsdale Prather |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780220111 PECOS PAC ID: 8022425511 Enrollment ID: I20210330000388 |
| Provider Name | Kristi Michelle Augustine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205330099 PECOS PAC ID: 4688921356 Enrollment ID: I20210816000134 |
| Provider Name | Carlie Field |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346635786 PECOS PAC ID: 6002137726 Enrollment ID: I20211020001642 |
| Provider Name | Georgia Jorgensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013632413 PECOS PAC ID: 0446627293 Enrollment ID: I20221108000102 |
| Provider Name | Malia Swanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548754419 PECOS PAC ID: 8820327745 Enrollment ID: I20221108002243 |
| Provider Name | Brian Kristoff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093158842 PECOS PAC ID: 4284925561 Enrollment ID: I20221108002691 |
| Provider Name | Ashley Elizabeth Moody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356857007 PECOS PAC ID: 8022486463 Enrollment ID: I20221116001626 |
| Provider Name | Patra Jane Zambetis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871212407 PECOS PAC ID: 1254709603 Enrollment ID: I20221116002180 |
| Provider Name | Eleanor Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073997458 PECOS PAC ID: 0749598431 Enrollment ID: I20221116003319 |
| Provider Name | Seyed Sahand Banisadr |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871013656 PECOS PAC ID: 7911245758 Enrollment ID: I20221212000229 |
| Provider Name | Marivel Martinez Cuevas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518414267 PECOS PAC ID: 3476928300 Enrollment ID: I20230406002806 |
| Provider Name | Claire M Ojima |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861811267 PECOS PAC ID: 7214220417 Enrollment ID: I20230426000890 |
| Provider Name | Kathryn Irene Garner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003435306 PECOS PAC ID: 4385067388 Enrollment ID: I20230504003124 |
| Provider Name | Alexandra Patricia Bader |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700349065 PECOS PAC ID: 1759615701 Enrollment ID: I20230725000388 |
| Provider Name | Betsy Anne Seguin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225737067 PECOS PAC ID: 5890140347 Enrollment ID: I20231018002586 |
| Provider Name | Annabella Lipinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447037346 PECOS PAC ID: 2567818925 Enrollment ID: I20231023000414 |
| Provider Name | Francisco Prada |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609257690 PECOS PAC ID: 8628387628 Enrollment ID: I20231025000701 |
| Provider Name | Anna Nadya Vavra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306527999 PECOS PAC ID: 2567819006 Enrollment ID: I20231106001895 |
| Provider Name | Alexandra Grace Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548886351 PECOS PAC ID: 0547682213 Enrollment ID: I20231109001114 |
Intermountain Health Good Samaritan Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 Exempla Cir, Lafayette, CO 80026 Phone: 303-689-4000 Fax: 303-467-4156 | |
Mental Health Partners Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1455 Dixon Ave, Lafayette, CO 80026 Phone: 303-443-8500 Fax: 303-413-6256 | |
Partners In Health Healing Arts Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 308 W Baseline Rd, Lafayette, CO 80026 Phone: 303-543-9504 Fax: 303-543-9729 | |
Community Medical Assoc Of Bch Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 W South Boulder Rd Ste 214, Lafayette, CO 80026 Phone: 303-415-4325 Fax: 303-661-9496 | |
Banner Greeley Specialists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 Exempla Cir, Suite 200, Lafayette, CO 80026 Phone: 970-378-4433 | |
Mental Health Partners Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1455 Dixon Ave, Lafayette, CO 80026 Phone: 303-443-8500 Fax: 720-687-2752 | |
Arcpoint Labs Lafayette/boulder Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 W South Boulder Rd Ste 103, Lafayette, CO 80026 Phone: 303-954-9864 Fax: 303-963-5782 |