NPIMap

Individual provider Active NPI

Brennan Smith

  • Physician Assistant
  • Arvada, CO
National Provider Identifier
1255922670
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
12650 W 64TH Ave Unit E501
Arvada, CO 80004-3893
Phone
(303) 431-4127
Fax
(303) 431-4553
NPI assigned
Jan 28, 2021
Last updated
Jul 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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 NU Primary

Addresses

Primary practice location

12650 W 64TH Ave Unit E501
Arvada, CO 80004-3893

Mailing address

12650 W 64TH Ave Unit E501
Arvada, CO 80004-3893
Phone (303) 431-4127

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
I20220801002396 CO Practitioner - Physician Assistant 1254713605 Reassigns benefits to 1 organization

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
Long Term Care and Rehab ConsultantsGroup PAC ID 5294733861, 58 clinicians

Practice addresses (Care Compare)

7481 Knox PL
Westminster, CO 80030-4818
Phone (303) 427-7101

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.97 of 100Reported as group
Quality
73.18
Improvement activities
40
Cost
65.91

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
LTC Urgent Services, LLC CurrentSince Jul 24, 2022 Accepting new patients

Locations

12650 W 64th Ave
Unit E501
Arvada, CO 80004
Phone (303) 431-4127

Organizations & group practices 2

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1255922670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12650 W 64TH AVE UNIT E501",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800043893",
            "telephone_number": "303-431-4127",
            "fax_number": "303-431-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12650 W 64TH AVE UNIT E501",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800043893",
            "telephone_number": "303-431-4127",
            "fax_number": "303-431-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRENNAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-28",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

Verify at the official NPI Registry.