| Family Medicine Associates, Pc | |
|
1022 Depot Hill Rd Broomfield CO 80020-1068 | |
| (303) 487-8817 | |
| (303) 487-0429 |
| Full Name | Family Medicine Associates, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1022 Depot Hill Rd, Broomfield, Colorado |
| Authorized Official Name and Position | Elisabeth Kandel (OWNER) |
| Authorized Official Contact | 3034878817 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Associates, Pc 8853 Fox Dr Ste 200 Thornton CO 80260-6864 Ph: (303) 487-8817 | Family Medicine Associates, Pc 1022 Depot Hill Rd Broomfield CO 80020-1068 Ph: (303) 487-8817 |
| NPI Number | 1457306862 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 12/20/2021 |
| Medicare PECOS PAC ID | 6406760313 |
|---|---|
| Medicare Enrollment ID | O20031114000649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457306862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | David C Leistikow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437241874 PECOS PAC ID: 1658285572 Enrollment ID: I20100901000807 |
| Provider Name | Alejandro Bustamante |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407058142 PECOS PAC ID: 5395984108 Enrollment ID: I20140211000747 |
| Provider Name | Julianna V Taylor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1851797104 PECOS PAC ID: 3870816770 Enrollment ID: I20141230000595 |
| Provider Name | Amanda Black |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609251073 PECOS PAC ID: 7214231638 Enrollment ID: I20160205000250 |
| Provider Name | Shantell M Twobears |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588685820 PECOS PAC ID: 2062478118 Enrollment ID: I20171101001247 |
| Provider Name | Jon Blauw |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295224020 PECOS PAC ID: 7214269331 Enrollment ID: I20191023000049 |
| Provider Name | Nathaniel Civili |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003457276 PECOS PAC ID: 3971924945 Enrollment ID: I20200528003369 |
| Provider Name | Lora Lynn Shima |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154046753 PECOS PAC ID: 3577939347 Enrollment ID: I20221019001346 |
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