NPIMap

Susan Graham, PA

Individual provider Active NPI Physician Assistant · Longmont, CO

NPI 1043307192 · NPPES record last updated Apr 22, 2025

Key facts

NPI
1043307192
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
Practice address
1308 Vivian St
Longmont, CO 80501-3217
Phone
(800) 628-7828
NPI assigned
Oct 9, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 6

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 Care Compare profile

Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rocky Mountain Clinics LLC (49 clinicians)

Practice addresses (Care Compare)

1410 Vance St
Suite 211
Lakewood, CO 80214-5435
Phone (720) 636-6537

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20100330000313 CO Practitioner - Physician Assistant 6507992534 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Clinics, LLC Current
since Apr 14, 2025		 Accepting new patients
Rocky Mountain Clinics LLC Current
since Apr 14, 2025		 Accepting new patients
Front Range Clinic Inc. Past
since Dec 22, 2020		 Accepting new patients
Rocky Mountain Clinics LLC Past
since Mar 12, 2024		 Accepting new patients
Premier Pain Management LLC Past Accepting new patients

Locations (25 of 34)

3324 Clark St
Alamosa, CO 81101

8725 Wadsworth Blvd
Ste C
Arvada, CO 80003

2224 S Fraser St
Unit 3
Aurora, CO 80014
Phone (720) 484-4428

4720 Table Mesa Dr
Ste B100
Boulder, CO 80305
Phone (720) 476-7957

1121 Main St
Canon City, CO 81212
Phone (719) 275-5261

1861 Austin Bluffs Pkwy
Colorado Springs, CO 80918
Phone (719) 419-7735

7190 Colorado Blvd
Ste 340
Commerce City, CO 80022
Phone (303) 467-2624

35 N Ash St
Cortez, CO 81321
Phone (970) 565-4109

390 Yampa Ave
Craig, CO 81625
Phone (662) 625-7118

2240 Blake St
Ste 101
Denver, CO 80205
Phone (720) 664-7183

1485 Florida Rd
Ste 203C
Durango, CO 81301
Phone (970) 247-9415

702 W Drake Rd
Ste D
Fort Collins, CO 80526

1120 E Elizabeth St
Ste G2
Fort Collins, CO 80524
Phone (970) 443-8268

1120 E Elizabeth St
Ste 2
Fort Collins, CO 80524

1040 E Elizabeth St
Ste B
Fort Collins, CO 80524
Phone (307) 760-9818

360 Peak One Dr
#110D
Frisco, CO 80443
Phone (303) 867-5309

17301 W Colfax Ave
Ste 275
Golden, CO 80401
Phone (303) 681-1894

2478 Patterson Rd
Ste 18
Grand Junction, CO 81505
Phone (970) 644-5303

8223 W 20th St
Ste 100A
Greeley, CO 80634
Phone (970) 702-2705

304 W Tomichi Ave
Ste 23
Gunnison, CO 81230
Phone (970) 644-5303

313 W 3rd St
Ste 200
La Junta, CO 81050
Phone (209) 309-1885

8015 W Alameda Ave
Ste 260
Lakewood, CO 80226
Phone (303) 744-3477

1410 Vance St
Ste 211
Lakewood, CO 80214
Phone (720) 597-5576

11000 County Road GG.5
Las Animas, CO 81054
Phone (719) 456-2600

1308 Vivian St
Longmont, CO 80501
Phone (303) 682-9197

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1819 CO
Physician Assistant 363A00000X Yes

Addresses

Primary practice location

1308 Vivian St
Longmont, CO 80501-3217

Mailing address

1120 E Elizabeth St Ste 2
Fort Collins, CO 80524-4044
Phone (970) 493-9193

Other identifiers

IdentifierTypeStateIssuer
51153203MedicaidCO

Other providers in Longmont, CO

All providers in Longmont, CO · Physician Assistant in Colorado

Sources for this page

Verify at the official NPI Registry.