Individual provider Active NPI

Catherine A Kushner

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1104225614
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0004101 Issued in CO
Practice address
4567 E 9TH Ave
Denver, CO 80220-3908
Phone
(303) 320-2455
Fax
(303) 306-7753
NPI assigned
Aug 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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 PA.0004101 CO
Physician Assistant 363A00000X PA.0004101 CO Primary

Addresses

Primary practice location

4567 E 9TH Ave
Denver, CO 80220-3908

Mailing address

PO Box 173862
Denver, CO 80217-3862
Phone (303) 306-7783

Other identifiers 1

IdentifierTypeStateIssuer
18070035MedicaidCO

Other names 1

  • Catherine A Kushner Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20141028000443 CO Practitioner - Physician Assistant 9739300153 Reassigns benefits to 2 organizations

National Provider Directory

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1104225614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 173862",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802173862",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4567 E 9TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802203908",
            "telephone_number": "303-320-2455",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSHNER",
        "first_name": "CATHERINE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0004101",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18070035",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "KUSHNER",
            "middle_name": "A",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.