Individual provider Active NPI

Rachel Elizabeth Printy, PA-C

  • Physician Assistant
  • Lakewood, CO
National Provider Identifier
1104138916
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113859 Issued in FL
Practice address
3455 S Yarrow St
Lakewood, CO 80227-5031
Phone
(303) 989-5231
Fax
(303) 989-9785
NPI assigned
Jul 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9113859 FL Primary

Addresses

Primary practice location

3455 S Yarrow St
Lakewood, CO 80227-5031

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 532-1355

Other identifiers 1

IdentifierTypeStateIssuer
109643600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100914000271 FL Practitioner - Physician Assistant 3870618911 Reassigns benefits to 1 organization
I20220420000371 CO Practitioner - Physician Assistant 3870618911 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Florida College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Advanced Dermatology LLCGroup PAC ID 0143208827, 21 clinicians

Practice addresses (Care Compare)

3455 S Yarrow St
Lakewood, CO 80227-5031
Phone (303) 989-5231

7950 Kipling St
Suite 102
Arvada, CO 80005-3929
Phone (303) 424-6248

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9113859FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Mar 15, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 16, 2018 Accepting new patients
Baycare Medical Group, Inc. Physician Assistant CurrentSince Mar 15, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 16, 2018 Accepting new patients
Fpa Hospital Based CurrentSince Jun 1, 2013 Accepting new patients
Ambulatory Care Physicians of Sarasota LLC Past Accepting new patients
Total Vision Eye Care Group LLC Past Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients
Northport Emergency Associates, PA Past Accepting new patients
Denver Dermatology Consultants PC PastSince Jun 1, 2022 Accepting new patients
Sarasota Emergency Associates PA Past Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

Interoperability endpoints

  • Direct secure messaging: rachel.printy@direct.mybaycare.org
  • Direct secure messaging: rprinty@center4advderm.emadirect.md

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1104138916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-532-1355",
            "fax_number": "813-635-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 S YARROW ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802275031",
            "telephone_number": "303-989-5231",
            "fax_number": "303-989-9785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINTY",
        "first_name": "RACHEL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109643600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.