NPIMap

Individual provider Active NPI

Keri Clark, PA-C

  • Surgical Physician Assistant
  • Highlands Ranch, CO
National Provider Identifier
1043885890
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0006847 Issued in CO
Practice address
1500 Park Central Dr Ste 301
Highlands Ranch, CO 80129-6694
Phone
(303) 265-3940
NPI assigned
May 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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 PA.0006847 CO Primary

Addresses

Primary practice location

1500 Park Central Dr Ste 301
Highlands Ranch, CO 80129-6694

Mailing address

PO Box 110429
Aurora, CO 80042-0429

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
I20210907001529 CO Practitioner - Physician Assistant 9133525793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

1500 Park Central Dr
Highlands Ranch, CO 80129-6688
Phone (720) 516-1100

Hospital & facility affiliations

  • Uchealth Highlands Ranch Hospital Hospital, Highlands Ranch, CO, CCN 060132
  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024
  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated Urology CurrentSince Sep 1, 2021 Accepting new patients
University Physicians, Incorporated CurrentSince Sep 1, 2021 Accepting new patients
University Physicians Incorporated Physician Assistant Past Accepting new patients
University Physicians Incorporated Urology PastSince Sep 1, 2021 Accepting new patients

Locations

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

1500 Park Central Dr
Ste 201
Highlands Ranch, CO 80129
Phone (720) 516-1094

1500 Park Central Dr
Ste 301
Highlands Ranch, CO 80129
Phone (303) 265-3940

1500 Park Central Dr
Littleton, CO 80129
Phone (720) 516-1000

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 and National Provider Directory roles.

Hospital & facility affiliations 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1043885890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PARK CENTRAL DR STE 301",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801296694",
            "telephone_number": "303-265-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KERI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2022-07-13",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0006847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

Verify at the official NPI Registry.