Family Medicine Associates, Pc | |
1022 Depot Hill Rd Broomfield CO 80020-1068 | |
(303) 487-8817 | |
(303) 487-0429 |
Full Name | Family Medicine Associates, Pc |
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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 |
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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 |
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Provider Enumeration Date | 05/24/2006 |
Last Update Date | 12/20/2021 |
Medicare PECOS PAC ID | 6406760313 |
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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 |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1437241874 PECOS PAC ID: 1658285572 Enrollment ID: I20100901000807 |
Provider Name | Alejandro Bustamante |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1407058142 PECOS PAC ID: 5395984108 Enrollment ID: I20140211000747 |
Provider Name | Julianna V Taylor |
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Provider Type | Practitioner - Physician Assistant |
Provider Identifiers | NPI Number: 1851797104 PECOS PAC ID: 3870816770 Enrollment ID: I20141230000595 |
Provider Name | Amanda Black |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609251073 PECOS PAC ID: 7214231638 Enrollment ID: I20160205000250 |
Provider Name | Shantell M Twobears |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1588685820 PECOS PAC ID: 2062478118 Enrollment ID: I20171101001247 |
Provider Name | Jon Blauw |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1295224020 PECOS PAC ID: 7214269331 Enrollment ID: I20191023000049 |
Provider Name | Nathaniel Civili |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003457276 PECOS PAC ID: 3971924945 Enrollment ID: I20200528003369 |
Provider Name | Lora Lynn Shima |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154046753 PECOS PAC ID: 3577939347 Enrollment ID: I20221019001346 |
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