Individual provider Active NPI

Mary Quigg, PA-C

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1336538776
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0004903 Issued in CO
Practice address
311 Steele St
Denver, CO 80206-4479
Phone
(303) 372-4000
Fax
(303) 372-4001
NPI assigned
Jan 22, 2015
Last updated
Jan 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA057358 PA
Physician Assistant 363A00000X PA0004903 CO Primary

Addresses

Primary practice location

311 Steele St
Denver, CO 80206-4479

Mailing address

311 Steele St
Denver, CO 80206-4479
Phone (303) 372-4000

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
I20170802002559 CO Practitioner - Physician Assistant 5496057861 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA0004903COMDPhysician Assistant
MA057358PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Sep 11, 2017 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 11, 2017 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

311 Steele St
Denver, CO 80206
Phone (303) 372-4000

11083 Colorado Blvd
Firestone, CO 80504
Phone (303) 833-8880

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

Organizations & group practices 2

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": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1336538776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 STEELE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802064479",
            "telephone_number": "303-372-4000",
            "fax_number": "303-372-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 STEELE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802064479",
            "telephone_number": "303-372-4000",
            "fax_number": "303-372-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIGG",
        "first_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA057358",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0004903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.