Individual provider Active NPI

Ayesha Rehman, M.D.

  • Psychiatry Physician
  • Greeley, CO
National Provider Identifier
1265672711
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DR.0054084 Issued in CO
Practice address
1300 N 17TH Ave
Greeley, CO 80631-9584
Phone
(970) 347-2120
NPI assigned
Feb 24, 2009
Last updated
Jan 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X DR.0054084 CO Primary

Addresses

Primary practice location

1300 N 17TH Ave
Greeley, CO 80631-9584

Mailing address

1300 N 17TH Ave
Greeley, CO 80631-9584
Phone (970) 347-2120

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150211001940 CO Practitioner - Psychiatry 7113175142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Range Behavioral HealthGroup PAC ID 1951299486, 20 clinicians

Practice addresses (Care Compare)

1300 N 17TH Ave
Greeley, CO 80631-9584
Phone (970) 347-2120

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0054084COMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Range Behavioral Health CurrentSince Dec 21, 2014 Accepting new patients
North Range Behavioral Health CurrentSince Dec 21, 2014 Accepting new patients
North Range Behavioral Health Current Accepting new patients

Locations

1300 N 17th Ave
Greeley, CO 80631
Phone (970) 475-6016

1407 8th Ave
Greeley, CO 80631
Phone (970) 347-2121

7251 W 20th St
Unit C
Greeley, CO 80634
Phone (970) 347-2123

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1265672711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 17TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806319584",
            "telephone_number": "970-347-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 17TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806319584",
            "telephone_number": "970-347-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REHMAN",
        "first_name": "AYESHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0054084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.