Active NPI
Patricia S Heller, PA
- Physician Assistant
- Boulder, CO
National Provider Identifier
1245367218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 649
- Practice address
- 580 Mohawk Dr
Boulder, CO 80303-3712 - Phone
- (303) 554-5205
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 649 | CO | Primary |
Addresses
Primary practice location
580 Mohawk Dr
Boulder, CO 80303-3712
Mailing address
580 Mohawk Dr
Boulder, CO 80303-3712
Phone (303) 554-5185
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42928257 | Medicaid | CO | |
| 008270 | Other | KAISER-COMMERCIAL NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 649 | CO | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281484800000",
"number": "1245367218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "580 MOHAWK DR",
"city": "BOULDER",
"state": "CO",
"postal_code": "803033712",
"telephone_number": "303-554-5185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "580 MOHAWK DR",
"city": "BOULDER",
"state": "CO",
"postal_code": "803033712",
"telephone_number": "303-554-5205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HELLER",
"first_name": "PATRICIA",
"middle_name": "S",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2010-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "649",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42928257",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER-COMMERCIAL NUMBER",
"identifier": "008270",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.