Individual provider Active NPI

Vaheed Weston Fakoor Sevvom, PA-C

  • Physician Assistant
  • Lakewood, CO
National Provider Identifier
1043404817
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2706 Issued in CO
Practice address
1746 Cole Blvd Ste 100
Lakewood, CO 80401-3208
Phone
(303) 914-8800
NPI assigned
Sep 4, 2007
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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 2706 CO Primary

Addresses

Primary practice location

1746 Cole Blvd Ste 100
Lakewood, CO 80401-3208

Mailing address

1746 Cole Blvd Ste 100
Lakewood, CO 80401-3208

Other practice location 1

5387 Manhattan Cir
Suite 200
Boulder, CO 80303-4284
Phone (303) 494-7773

Other identifiers 1

IdentifierTypeStateIssuer
72327715MedicaidCO

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
I20090130000186 CO Practitioner - Physician Assistant 3072677400 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diversified Radiology of Colorado IncGroup PAC ID 0143132316, 92 clinicians

Practice addresses (Care Compare)

Denver, CO 80209
Phone (303) 914-8800

1600 Prairie Ctr Pkwy
Brighton, CO 80601-4006
Phone (303) 914-8800

1719 E 19TH Ave
Denver, CO 80218-1235
Phone (303) 914-8800

4567 E 9TH Ave
Denver, CO 80220-3908
Phone (303) 914-8800

9191 Grant St
Thornton, CO 80229-4361
Phone (303) 914-8800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2706COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Emergency Group, Inc Past Accepting new patients

Organizations & group practices 4

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 3

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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1043404817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1746 COLE BLVD STE 100",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1746 COLE BLVD STE 100",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013208",
            "telephone_number": "303-914-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5387 Manhattan Cir",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803034284",
            "country_code": "US",
            "telephone_number": "303-494-7773",
            "fax_number": "303-494-1104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAKOOR SEVVOM",
        "first_name": "VAHEED",
        "middle_name": "WESTON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72327715",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.