| Western Infectious Disease Consultants, P.c. | |
|
3885 Upham St Suite 200 Wheat Ridge CO 80033-4880 | |
| (303) 425-9245 | |
| (303) 425-1378 |
| Full Name | Western Infectious Disease Consultants, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 3885 Upham St, Wheat Ridge, Colorado |
| Authorized Official Name and Position | Jeffrey A Desjardin (PRESIDENT) |
| Authorized Official Contact | 3034259245 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Infectious Disease Consultants, P.c. Po Box 1449 Wheat Ridge CO 80034-1449 Ph: (303) 425-9245 | Western Infectious Disease Consultants, P.c. 3885 Upham St Suite 200 Wheat Ridge CO 80033-4880 Ph: (303) 425-9245 |
| NPI Number | 1598828949 |
|---|---|
| Provider Enumeration Date | 12/18/2006 |
| Last Update Date | 06/29/2016 |
| Medicare PECOS PAC ID | 6305736786 |
|---|---|
| Medicare Enrollment ID | O20040318000931 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598828949 | NPI | - | NPPES |
| 04007191 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Mary Ann Degroote |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1083696827 PECOS PAC ID: 2163320169 Enrollment ID: I20031229000913 |
| Provider Name | Jeffrey A Desjardin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1821191305 PECOS PAC ID: 1557325115 Enrollment ID: I20101208000553 |
| Provider Name | Brent Wade Wieland |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1154464766 PECOS PAC ID: 9133294192 Enrollment ID: I20110825000081 |
| Provider Name | Marinka Kartalija |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1194763086 PECOS PAC ID: 7315109055 Enrollment ID: I20120425000744 |
| Provider Name | Sonali Hemachandra |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1063578516 PECOS PAC ID: 4789725789 Enrollment ID: I20130919000726 |
| Provider Name | Charlotte Louise Ellenbogen |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1417914540 PECOS PAC ID: 0547271900 Enrollment ID: I20140717002127 |
| Provider Name | Amber Marie Noon |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1629273321 PECOS PAC ID: 8022206739 Enrollment ID: I20140718001567 |
| Provider Name | Katherine Mirro Johnson |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1083888937 PECOS PAC ID: 8426274986 Enrollment ID: I20140718002049 |
| Provider Name | Benjamin H White |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1588925044 PECOS PAC ID: 8729344916 Enrollment ID: I20171103000238 |
| Provider Name | Laura O Coster |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1780855247 PECOS PAC ID: 5991875916 Enrollment ID: I20171108000732 |
| Provider Name | Teresa Amanda Cushman |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1063775005 PECOS PAC ID: 5890005045 Enrollment ID: I20190529002500 |
| Provider Name | Angela Marie Budgin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1700272465 PECOS PAC ID: 6204142755 Enrollment ID: I20200522001449 |
| Provider Name | Swati Vempati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982066320 PECOS PAC ID: 1557653466 Enrollment ID: I20210526003446 |
| Provider Name | Arianna Kousari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194220889 PECOS PAC ID: 2668728783 Enrollment ID: I20230516000746 |
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