NPIMap

Individual provider Active NPI

Ryan James Shephard, PA-C

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1326722703
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0007847 Issued in CO
Practice address
1360 S Potomac St
Aurora, CO 80012-4505
Phone
(303) 337-5575
NPI assigned
Jun 14, 2023
Last updated
Jun 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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 PA.0007847 CO Primary

Addresses

Primary practice location

1360 S Potomac St
Aurora, CO 80012-4505

Mailing address

13757 W Amherst Way
Lakewood, CO 80228-4967
Phone (303) 653-8596

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
I20230705002036 CO Practitioner - Physician Assistant 2062871361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mauricio Waintrub, M.D., P.CGroup PAC ID 0042118192, 27 clinicians

Practice addresses (Care Compare)

1360 S Potomac St
Aurora, CO 80012-4505

56441 E Colfax Ave
Strasburg, CO 80136-7741
Phone (303) 337-5575

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0007847COMDPhysician Assistant

Organizations & group practices 1

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 11

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": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1326722703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13757 W AMHERST WAY",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802284967",
            "telephone_number": "303-653-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 S POTOMAC ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124505",
            "telephone_number": "303-337-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHARD",
        "first_name": "RYAN",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.