Miranda E Prejean

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0003573 Issued in CO

Practice address

1950 Mountain View Ave
Longmont, CO 80501-3129

Phone

(303) 306-7783

Fax

(303) 306-7753

NPI assigned

Mar 21, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miranda E Heuer Former name

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Carbon Health Medical Group of Florida PAGroup PAC ID 3274947304, 55 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital, the Hospital, Craig, CO, CCN 061314

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Carbon Health Medical Group of Florida PA

  • Urgent Care Clinic/Center
  • Littleton, CO
  • NPI 1730781691
  Medicare reassignment Care Compare group NPD
• Colorado Permanente Medical Group, P.C.

  • Internal Medicine Physician
  • Denver, CO
  • NPI 1760599724
  Medicare reassignment Care Compare group
• New West Physicians Inc

  • Internal Medicine Physician
  • Golden, CO
  • NPI 1427010859

  Physician Assistant

  Medicare reassignment NPD
• The Memorial Hospital

  • Critical Access Hospital
  • Craig, CO
  • NPI 1063418424
  Medicare reassignment NPD (past)
• The Memorial Hospital

  • Land Ambulance
  • Craig, CO
  • NPI 1669288809
  NPD
• The Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Steamboat Springs, CO
  • NPI 1750958229
  NPD
• Carbon Health Medical Group of Florida PA

  • Urgent Care Clinic/Center
  • Oro Valley, AZ
  • NPI 1396317079
  NPD
• Longs Peak Emergency Physicians, PC

  • Emergency Medicine Physician
  • Longmont, CO
  • NPI 1215910146
  NPD (past)

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

• The Memorial Hospital

  • Critical Access Hospital
  • Craig, CO
  • NPI 1063418424
  Care Compare affiliation
• The Memorial Hospital

  • Land Ambulance
  • Craig, CO
  • NPI 1669288809

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1043552607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013129",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 S Parker Rd",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800141622",
            "country_code": "US",
            "telephone_number": "303-338-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PREJEAN",
        "first_name": "MIRANDA",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0003573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76736776",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2550 S Parker Rd",
            "city": "Aurora",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800141622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "HEUER",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Lewis Powell, M.D.
• Diana Marie Prado Carrillo, LMT
• Robert M Prater, PHYSICAL THEAPIST
• Allison Pratt, LCSW
• Sharon L Pratt, PT
• Premere Rehab, LLC
• Whitney Prestwood, M.A.
• Kevin E Price
• Nicole Price, LPN
• Danielle Prince

• Physician Assistant in Longmont, CO
• Providers in Longmont, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.