Individual provider Active NPI

Nathan Donald Rud, PA

  • Medical Physician Assistant
  • Aurora, CO
National Provider Identifier
1255689477
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0006146 Issued in CO
Practice address
12605 E 16TH Ave
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Aug 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.004331 IL
Medical Physician Assistant 363AM0700X PA.0006146 CO Primary

Addresses

Primary practice location

12605 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130122000308 IL Practitioner - Physician Assistant 5294988473
I20200713000152 CO Practitioner - Physician Assistant 5294988473 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as group
Quality
91.15
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.004331ILMDPhysician Assistant
PA.0006146COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Emergency Services, Inc CurrentSince Oct 15, 2021 Accepting new patients
Usacs of Colorado Inc CurrentSince Oct 15, 2021 Accepting new patients
Usacs of Colorado Inc CurrentSince Oct 15, 2021 Accepting new patients
Usacs Observation Medicine Services of Colorado Inc. CurrentSince Oct 15, 2021 Accepting new patients
Northwest Community Hospital CurrentSince Dec 17, 2013 Accepting new patients
Usacs Community Emergency Services of Colorado, Inc. CurrentSince Nov 1, 2021 Accepting new patients
Northwest Community Hospital Past Accepting new patients
Emergency Professionals of Colorado, PC Physician Assistant Past Accepting new patients
Emergency Professionals of Colorado, PC Physician Assistant Past Accepting new patients
Emergency Professionals of Colorado, PC Physician Assistant Past Accepting new patients
Emergency Professionals of Colorado, PC Physician Assistant Past Accepting new patients

Locations

16320 W 64th Ave
Arvada, CO 80007
Phone (303) 925-4560

7000 E Hampden Ave
Denver, CO 80224
Phone (330) 925-4199

11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-1010

7700 S Broadway
Littleton, CO 80122
Phone (303) 269-4786

2551 W 84th Ave
Westminster, CO 80031
Phone (303) 202-1280

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1255689477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12605 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUD",
        "first_name": "NATHAN",
        "middle_name": "DONALD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-20",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.004331",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0006146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.