Organization Active NPI

Presken Family Care PC

  • Family Medicine Physician
  • Centennial, CO
National Provider Identifier
1134518467
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
42711 Issued in CO
Legal business name
PRESKEN FAMILY CARE PC
Practice address
20971 E Smoky Hill Rd
Suite 107
Centennial, CO 80015-5186
Phone
(720) 556-2001
NPI assigned
Jan 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Authorized official

Name
Dr. Deborah Shira Presken, M.D.NPI 1700074846
Title
Physician Owner
Phone
(720) 556-2001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 42711 CO Primary

Addresses

Primary practice location

20971 E Smoky Hill Rd
Suite 107
Centennial, CO 80015-5186

Mailing address

20971 E Smoky Hill Rd
Suite 107
Centennial, CO 80015-5186
Phone (720) 556-2001

Other identifiers 1

IdentifierTypeStateIssuer
44120265MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150428002057 CO Part B Supplier - Clinic/Group Practice 8820317696 Receives reassigned benefits from 1 practitioner
Practice locations: Centennial, CO

National Provider Directory

National Provider Directory

Locations

13111 E Briarwood Ave
Ste 360
Centennial, CO 80112
Phone (720) 556-2001

20971 E Smoky Hill Rd
Ste 107
Centennial, CO 80015
Phone (720) 556-2001

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10547/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1134518467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20971 E SMOKY HILL RD",
            "address_2": "SUITE 107",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800155186",
            "telephone_number": "720-556-2001",
            "fax_number": "720-489-3731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20971 E SMOKY HILL RD",
            "address_2": "SUITE 107",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800155186",
            "telephone_number": "720-556-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESKEN FAMILY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "PRESKEN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "SHIRA",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "720-556-2001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "42711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44120265",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.