Nicole Gundersen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

175 S Union Blvd Ste 200
Colorado Springs, CO 80910-3117

Phone

(719) 372-5555

NPI assigned

Nov 8, 2019

Last updated

Jan 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ngundersen1259302@nychhc.direct-ci.com
• Direct secure messaging: nicole.gundersen.p1@direct.americanvein.nextgenshare.com

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.

• Rocky Mountain Vein Institute Professional LLC

  dba American Vein & Vascular

  • Vascular & Interventional Radiology Physician
  • Pueblo, CO
  • NPI 1457685398
  Medicare reassignment NPD
• Rocky Mountain Vein Institute, PLLC

  • Vascular & Interventional Radiology Physician
  • Lakewood, CO
  • NPI 1811613912
  NPD
• Rocky Mountain Vein Institute, PLLC

  • Vascular & Interventional Radiology Physician
  • Colorado Springs, CO
  • NPI 1457942898
  NPD (past)

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1306481734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7702",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805370702",
            "telephone_number": "970-663-2742",
            "fax_number": "970-342-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S UNION BLVD STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103117",
            "telephone_number": "719-372-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSEN",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-08",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trinity Gulliford, RBT
• Susan Michelle Gulya, FNP
• Tomeka Gumbs
• Ciera Gump
• Annabelle Gunden
• Vinod Krishnahari Gundu, MD
• Joseph Mmichael Gungler, RPH
• Sarah R Gunlikson, PA-C
• Alpha Marcella Gunn, MA, LPC
• Kelly Joy Gunn, NP

• Physician Assistant in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.