Individual provider Active NPI

Cora Rose Matteson, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1184958092
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2825 Issued in CO
Practice address
12250 E Iliff Ave
#300
Aurora, CO 80014-6318
Phone
(303) 306-4321
Fax
(720) 524-1551
NPI assigned
Sep 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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 2825 CO Primary

Addresses

Primary practice location

12250 E Iliff Ave
#300
Aurora, CO 80014-6318

Mailing address

10900 W 44TH Ave Unit 200
Wheat Ridge, CO 80033-2742
Phone (303) 923-1239

Other identifiers 1

IdentifierTypeStateIssuer
23883871MedicaidCO

Other names 1

  • Cora Rose Lininger Former 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
I20100324001053 CO Practitioner - Physician Assistant 2567598972 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2825COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Colorado PC CurrentSince Dec 1, 2012 Accepting new patients
Live Well LTD Current Accepting new patients
Inpatient Consultants of Colorado, PC Physician Assistant Past Accepting new patients

Locations

12250 E Iliff Ave
Ste 300
Aurora, CO 80014
Phone (720) 524-1550

2000 S Colorado Blvd
Ste 420
Denver, CO 80222
Phone (720) 524-1550

Organizations & group practices 3

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": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1184958092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 W 44TH AVE UNIT 200",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332742",
            "telephone_number": "303-923-1239",
            "fax_number": "303-284-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12250 E ILIFF AVE",
            "address_2": "#300",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800146318",
            "telephone_number": "303-306-4321",
            "fax_number": "720-524-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTESON",
        "first_name": "CORA",
        "middle_name": "ROSE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23883871",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORA",
            "last_name": "LININGER",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.