Patrick Michael Cassidy, P.A.-C
Individual provider Active NPI Physician Assistant · Fountain, CO
NPI 1063666824 · NPPES record last updated Feb 19, 2020
Key facts
- NPI
- 1063666824
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA.0002941 (CO)
- Practice address
- 350 Lyckman PL
Fountain, CO 80817-2861 - Phone
- (719) 322-0777
- Fax
- (719) 322-0776
- NPI assigned
- Nov 6, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 18
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2695 Rocky Mountain Ave
Suite 150
Loveland, CO 80538-8702
2695 Rocky Mountain Ave
Suite 150
Loveland, CO 80538-9071
3205 N Academy Blvd
Suite 130
Colorado Springs, CO 80917-5152
350 Lyckman PL
Fountain, CO 80817-2861
Hospital & facility affiliations
- Uch-Memorial Health System
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100503000843 | CO | Practitioner - Physician Assistant | 6204964885 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2941 | CO | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Vista Community Health Centers | Current |
Accepting new patients | |
| Poudre Valley Medical Group, LLC | Current |
Accepting new patients | |
| Peak Vista Community Health Centers | Current |
Accepting new patients | |
| Integrity Urgent Care, P.C. | Past | Accepting new patients |
Locations
16951 E Quincy Ave
Aurora, CO 80015
Phone (303) 752-5470
4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260
4404 Barranca Ln
Ste 101
Castle Rock, CO 80104
Phone (720) 733-5260
4404 Barranca Ln
Unit 101
Castle Rock, CO 80104
Phone (720) 733-5260
2767 Janitell Rd
Colorado Springs, CO 80906
Phone (719) 365-2888
13445 Voyager Pkwy
Colorado Springs, CO 80921
Phone (719) 219-0333
4323 Integrity Center Pt
Colorado Springs, CO 80917
Phone (719) 591-2558
3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873
1035 Garden of the Gods Rd
Ste 120
Colorado Springs, CO 80907
Phone (719) 329-1000
1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120
350 Lyckman Pl
Fountain, CO 80817
Phone (719) 322-0777
9475 S University Blvd
Highlands Ranch, CO 80126
Phone (303) 470-4061
8155 Piney River Ave
Ste 100
Littleton, CO 80125
Phone (303) 265-3370
2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412
11605 Meridian Market Vw
Ste 184
Peyton, CO 80831
Phone (719) 364-9555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 2941 | CO | |
| Physician Assistant | 363A00000X | PA.0002941 | CO | Yes |
Addresses
Primary practice location
350 Lyckman PL
Fountain, CO 80817-2861
Mailing address
2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4036
Other practice location 1
11605 Meridian Market Vw Ste 184
Falcon, CO 80831-8238
Phone (970) 624-2412
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 82629579 | Medicaid | CO |
Other providers in Fountain, CO
- Natalia Cardenas
- Ashley Carnahan
- Tammy Lynn Carney
- Claire Carpenter
- Kindee Lynn Carter
- Hannah Castro
- Cassandra Casul
- Catholic Health Initiatives Colorado
- Leslie Katherine Chaffin
- Sydney Ann Chappell
All providers in Fountain, CO · Physician Assistant in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.