NPIMap

Individual provider Active NPI

Patrick Michael Cassidy, P.A.-C

  • Physician Assistant
  • Fountain, CO
National Provider Identifier
1063666824
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0002941 Issued in CO
Practice address
350 Lyckman PL
Fountain, CO 80817-2861
Phone
(719) 322-0777
Fax
(719) 322-0776
NPI assigned
Nov 6, 2008
Last updated
Feb 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2941 CO
Physician Assistant 363A00000X PA.0002941 CO Primary

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

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
I20100503000843 CO Practitioner - Physician Assistant 6204964885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2941COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Aug 9, 2016 Accepting new patients
Peak Vista Community Health Centers CurrentSince Jan 26, 2012 Accepting new patients
Peak Vista Community Health Centers CurrentSince Jan 26, 2012 Accepting new patients
Poudre Valley Medical Group, LLC Past 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

1035 Garden of the Gods Rd
Ste 120
Colorado Springs, CO 80907
Phone (719) 329-1000

13445 Voyager Pkwy
Colorado Springs, CO 80921
Phone (719) 219-0333

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

2767 Janitell Rd
Colorado Springs, CO 80906
Phone (719) 365-2888

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

4323 Integrity Center Pt
Colorado Springs, CO 80917
Phone (719) 591-2558

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) 624-2403

11605 Meridian Market Vw
Ste 184
Peyton, CO 80831
Phone (719) 364-9555

Organizations & group practices 5

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1063666824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE",
            "address_2": "STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4036",
            "fax_number": "970-490-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 LYCKMAN PL",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808172861",
            "telephone_number": "719-322-0777",
            "fax_number": "719-322-0776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11605 Meridian Market Vw Ste 184",
            "address_purpose": "LOCATION",
            "city": "Falcon",
            "state": "CO",
            "postal_code": "808318238",
            "country_code": "US",
            "telephone_number": "970-624-2412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "PATRICK",
        "middle_name": "MICHAEL",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-06",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2941",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0002941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain, CO

Sources for this page

Verify at the official NPI Registry.