NPIMap

Individual provider Active NPI

Valentine Matongoh, PA-C

  • Physician Assistant
  • Englewood, CO
National Provider Identifier
1174239016
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0007730 Issued in CO
Practice address
3515 S Delaware St
Englewood, CO 80110-3529
Phone
(303) 778-7433
NPI assigned
Jan 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 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 PA.0007730 CO Primary

Addresses

Primary practice location

3515 S Delaware St
Englewood, CO 80110-3529

Mailing address

3515 S Delaware St
Englewood, CO 80110-3529
Phone (303) 778-7433

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
I20230809002148 CO Practitioner - Physician Assistant 9335501238 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Community Provider Network IncGroup PAC ID 0648181214, 41 clinicians

Practice addresses (Care Compare)

15132 E Hampden Ave
Suite G
Aurora, CO 80014-5038
Phone (303) 360-6276

3515 S Delaware St
Englewood, CO 80110-3529
Phone (303) 360-6276

7495 W 29TH Ave
Wheat Ridge, CO 80033-8002
Phone (303) 360-6276

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0007730COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Community Provider Network Inc Federally Qualified Health Center (FQHC) CurrentSince Aug 1, 2024 Accepting new patients
Metro Community Provider Network Inc Federally Qualified Health Center (FQHC) Current Accepting new patients
Metro Community Provider Network, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Metro Community Provider Network Inc Federally Qualified Health Center (FQHC) Past Accepting new patients

Locations

12400 E Jewell Ave
Unit A
Aurora, CO 80012

2255 S Oneida St
Denver, CO 80224

3515 S Delaware St
Englewood, CO 80110
Phone (303) 778-7433

17866 Cottonwood Dr
Parker, CO 80134
Phone (303) 205-6899

7495 W 29th Ave
Wheat Ridge, CO 80033
Phone (303) 239-9964

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 and National Provider Directory roles.

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1174239016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 S DELAWARE ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801103529",
            "telephone_number": "303-778-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 S DELAWARE ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801103529",
            "telephone_number": "303-778-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATONGOH",
        "first_name": "VALENTINE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-24",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.