NPIMap

Individual provider Active NPI

Kathryn Milizio, PA-C

  • Physician Assistant
  • Greeley, CO
National Provider Identifier
1023560034
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0004824 Issued in CO
Practice address
1900 16TH St
Greeley, CO 80631-5114
Phone
(970) 350-2438
Fax
(970) 350-2473
NPI assigned
Oct 26, 2016
Last updated
Oct 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0004824 CO Primary

Addresses

Primary practice location

1900 16TH St
Greeley, CO 80631-5114

Mailing address

1900 16TH St
Greeley, CO 80631-5114
Phone (970) 350-2438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161217000024 CO Practitioner - Physician Assistant 9133409782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

4617 W 20TH St
Unit a Select PT
Greeley, CO 80634-3207
Phone (970) 352-9022

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-3636

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jan 16, 2017 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jan 16, 2017 Accepting new patients

Locations

1900 16th St
Greeley, CO 80631
Phone (970) 350-2438

6767 29th St
Fl 2
Greeley, CO 80634
Phone (970) 652-2433

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1023560034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315114",
            "telephone_number": "970-350-2438",
            "fax_number": "970-350-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315114",
            "telephone_number": "970-350-2438",
            "fax_number": "970-350-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILIZIO",
        "first_name": "KATHRYN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.