Andrew R Stephenitch, MPT

Individual provider Active NPI Physical Therapist · Lone Tree, CO

NPI 1003943044 · NPPES record last updated Sep 6, 2022

Key facts

NPI
1003943044
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
7873 (CO)
Practice address
10240 Park Meadows Dr
Lone Tree, CO 80124-5425
Phone
(303) 338-4545
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050819000353 CO Practitioner - Physical Therapist in Private Practice 7416987342 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Permanente Medical Group, P.C. Current
since May 9, 2020
Accepting new patients
Brian Fee P.T., P. C. Physical Therapist Past Accepting new patients

Locations

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

2045 N Franklin St
Denver, CO 80205
Phone (303) 764-4666

14701 E Exposition Ave
Denver, CO 80012
Phone (303) 614-7373

10240 Park Meadows Dr
Lone Tree, CO 80124
Phone (303) 649-5639

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7873 CO Yes

Addresses

Primary practice location

10240 Park Meadows Dr
Lone Tree, CO 80124-5425

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314
Phone (303) 338-3382

Other practice location 1

2045 N Franklin St
Denver, CO 80205-5437
Phone (303) 338-4545

Other identifiers

IdentifierTypeStateIssuer
69200271MedicaidCO
015422OtherKAISER-COMMERCIAL NUMBER

Electronic endpoints

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Other providers in Lone Tree, CO

All providers in Lone Tree, CO · Physical Therapist in Colorado

Sources for this page

Verify at the official NPI Registry.