Individual provider Active NPI

Dean Levesque, PA-C

  • Surgical Physician Assistant
  • Golden, CO
National Provider Identifier
1265822308
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0004976 Issued in CO
Practice address
660 Golden Ridge Rd
Suite 250
Golden, CO 80401-9541
Phone
(303) 233-1223
Fax
(303) 233-8755
NPI assigned
Jan 28, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0010-05501 NC
Surgical Physician Assistant 363AS0400X 2492 SC
Surgical Physician Assistant 363AS0400X PA.0004976 CO Primary

Addresses

Primary practice location

660 Golden Ridge Rd
Suite 250
Golden, CO 80401-9541

Mailing address

660 Golden Ridge Rd
Suite 250
Golden, CO 80401-9541
Phone (303) 233-1223

Other identifiers 1

IdentifierTypeStateIssuer
2651PAMedicaidSC

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
I20170615001922 CO Practitioner - Physician Assistant 5092020511 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-05501NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Panorama Orthopedics & Spine Center, PC CurrentSince Jun 1, 2017 Accepting new patients
Panorama Orthopedics & Spine Center, PC CurrentSince Jun 1, 2017 Accepting new patients

Locations

660 Golden Ridge Rd
Ste 250
Golden, CO 80401
Phone (303) 274-7321

8510 Bryant St
Ste 120
Westminster, CO 80031
Phone (303) 452-8001

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1265822308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 GOLDEN RIDGE RD",
            "address_2": "SUITE 250",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804019541",
            "telephone_number": "303-233-1223",
            "fax_number": "303-233-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 GOLDEN RIDGE RD",
            "address_2": "SUITE 250",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804019541",
            "telephone_number": "303-233-1223",
            "fax_number": "303-233-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVESQUE",
        "first_name": "DEAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-28",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-05501",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "2492",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0004976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2651PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden, CO

Sources for this page

Verify at the official NPI Registry.