Individual provider Active NPI

Tabatha Alma Tomajko, PA-C

  • Surgical Physician Assistant
  • Lafayette, CO
National Provider Identifier
1013019108
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2898 Issued in CO
Practice address
300 Exempla Circle, Suite 360
Bluestone Advanced Surgical Care
Lafayette, CO 80026
Phone
(303) 689-6560
NPI assigned
Sep 1, 2006
Last updated
Dec 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2898 CO Primary

Addresses

Primary practice location

300 Exempla Circle, Suite 360
Bluestone Advanced Surgical Care
Lafayette, CO 80026

Mailing address

1995 E Coalton Rd
Apt 76-101
Superior, CO 80027-4419
Phone (203) 940-1367

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091119000609 CO Practitioner - Physician Assistant 9133136336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 Exempla Cir
Lafayette, CO 80026-3396

300 Exempla Cir
Suite 360 Im Heart and Vascular 360 Lafayet
Lafayette, CO 80026-3395
Phone (303) 272-0500

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2898COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Jan 1, 2015 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jan 1, 2015 Accepting new patients
Good Samaritan Medical Center, LLC CurrentSince Nov 1, 2009 Accepting new patients

Locations

200 Exempla Cir
Lafayette, CO 80026
Phone (303) 689-4110

300 Exempla Cir
Ste 360
Lafayette, CO 80026
Phone (303) 403-3030

300 Exempla Cir
Ste 400
Lafayette, CO 80026
Phone (303) 318-3240

Interoperability endpoints

  • Direct secure messaging: ttomajko24241@direct.intermountainhealth.org

Organizations & group practices 5

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1013019108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 E COALTON RD",
            "address_2": "APT 76-101",
            "city": "SUPERIOR",
            "state": "CO",
            "postal_code": "800274419",
            "telephone_number": "203-940-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 EXEMPLA CIRCLE, SUITE 360",
            "address_2": "BLUESTONE ADVANCED SURGICAL CARE",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "80026",
            "telephone_number": "303-689-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMAJKO",
        "first_name": "TABATHA",
        "middle_name": "ALMA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "2898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

Verify at the official NPI Registry.