Individual provider Active NPI

Alicia Gail Smith, PA-C

  • Medical Physician Assistant
  • Golden, CO
National Provider Identifier
1265498364
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2019 Issued in CO
Practice address
5920 McIntyre St
#504
Golden, CO 80403-7445
Phone
(303) 949-1250
NPI assigned
Apr 26, 2006
Last updated
Jan 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2019 CO Primary

Addresses

Primary practice location

5920 McIntyre St
#504
Golden, CO 80403-7445

Mailing address

5920 McIntyre St
#504
Golden, CO 80403-7445
Phone (303) 949-1250

Other identifiers 1

IdentifierTypeStateIssuer
65404785MedicaidCO

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
I20121107000395 CO Practitioner - Physician Assistant 4981636222 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Colorado PC CurrentSince Dec 1, 2010 Accepting new patients
Inpatient Consultants of Colorado, PC Past Accepting new patients
Flatirons Family Practice Inc PastSince Jan 9, 2011 Accepting new patients
Senior Care of Colorado, PC PastSince Sep 1, 2010 Accepting new patients

Locations

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

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1265498364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 MCINTYRE ST",
            "address_2": "#504",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804037445",
            "telephone_number": "303-949-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 MCINTYRE ST",
            "address_2": "#504",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804037445",
            "telephone_number": "303-949-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALICIA",
        "middle_name": "GAIL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65404785",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden, CO

Sources for this page

Verify at the official NPI Registry.