Active NPI
Thomas Matthew Stewart, PA-C
- Medical Physician Assistant
- Aurora, CO
National Provider Identifier
1093961559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA.0001187
- Practice address
- 12605 E 16TH Ave
Aurora, CO 80045 - Phone
- (303) 493-7000
- NPI assigned
- Aug 14, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.0001187 | CO | |
| Medical Physician Assistant | 363AM0700X | PA.0001187 | CO | Primary |
Addresses
Primary practice location
12605 E 16TH Ave
Aurora, CO 80045
Mailing address
PO Box 110429
Aurora, CO 80042-0429
Phone (303) 493-7000
Other practice location 1
700 Potomac St
Suite A
Aurora, CO 80011-6844
Phone (303) 360-3712
Other practice location 2
700 Potomac St
Suite A
Aurora, CO 80011-6844
Phone (303) 360-3712
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62202065 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541030400000",
"number": "1093961559",
"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",
"telephone_number": "303-493-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12605 E 16TH AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "80045",
"telephone_number": "303-493-7000"
}
],
"practiceLocations": [
{
"address_1": "700 Potomac St",
"address_2": "Suite A",
"address_purpose": "LOCATION",
"city": "Aurora",
"state": "CO",
"postal_code": "800116844",
"country_code": "US",
"telephone_number": "303-360-3712",
"fax_number": "303-467-5355",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "700 Potomac St",
"address_2": "Suite A",
"address_purpose": "LOCATION",
"city": "Aurora",
"state": "CO",
"postal_code": "800116844",
"country_code": "US",
"telephone_number": "303-360-3712",
"fax_number": "303-467-5355",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEWART",
"first_name": "THOMAS",
"middle_name": "MATTHEW",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-14",
"last_updated": "2018-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "PA.0001187",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "PA.0001187",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "62202065",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.