NPIMap

Individual provider Active NPI

Susan Alsharif, PA-C

  • Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1235811654
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0008155 Issued in CO
Practice address
4110 Briargate Pkwy Ste 460
Colorado Springs, CO 80920-7839
Phone
(719) 364-6487
Fax
(719) 364-6488
NPI assigned
Aug 4, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X PA.0008155 CO
Surgical Physician Assistant 363AS0400X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA.0008155 CO Primary

Addresses

Primary practice location

4110 Briargate Pkwy Ste 460
Colorado Springs, CO 80920-7839

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-2412

Other practice location 1

6675 Corporate Center Pkwy Ste 115
Jacksonville, FL 32216-8088
Phone (904) 245-8990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240805000492 CO Practitioner - Physician Assistant 6709323066 Reassigns benefits to 1 organization
I20240920003318 IL Practitioner - Physician Assistant 6709323066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1400 E Boulder
Suite 2410 Pre Procedure Memorial
Colorado Springs, CO 80909-5533
Phone (719) 365-6525

1400 E Boulder St
Colorado Springs, CO 80909-5533

4050 Briargate Pkwy
Colorado Springs, CO 80920-7815

4080 Briargate Pkwy
Colorado Springs, CO 80920-7815
Phone (719) 365-6800

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0008155COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Multi-Specialty CurrentSince Sep 3, 2024 Accepting new patients
Poudre Valley Medical Group, LLC Multi-Specialty Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

4110 Briargate Pkwy
Ste 460
Colorado Springs, CO 80920
Phone (719) 364-6487

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1691107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1235811654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-2412",
            "fax_number": "970-490-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 BRIARGATE PKWY STE 460",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207839",
            "telephone_number": "719-364-6487",
            "fax_number": "719-364-6488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6675 Corporate Center Pkwy Ste 115",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322168088",
            "country_code": "US",
            "telephone_number": "904-245-8990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALSHARIF",
        "first_name": "SUSAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-04",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0008155",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.