NPIMap

Individual provider Active NPI

Nikki D Ralston

  • Medical Physician Assistant
  • Denver, CO
National Provider Identifier
1346737483
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.006510 Issued in CO
Practice address
777 Bannock St # Mc3240
Denver, CO 80204-4597
Phone
(303) 436-6000
NPI assigned
Apr 14, 2018
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Medical Physician Assistant 363AM0700X PA.006510 CO Primary
Surgical Physician Assistant 363AS0400X

Addresses

Primary practice location

777 Bannock St # Mc3240
Denver, CO 80204-4597

Mailing address

PO Box 172263
Denver, CO 80217-2263
Phone (888) 987-7975

Other practice location 1

4700 Hale Pkwy Ste 330
Denver, CO 80220-4045
Phone (472) 044-1402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180521001357 VA Practitioner - Physician Assistant 1658636790 Reassigns benefits to 1 organization
I20210113000036 CO Practitioner - Physician Assistant 1658636790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Front Range Spine and NeurosurgeryGroup PAC ID 7214966720, 12 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

10099 Ridgegate Pkwy
Suite 310
Lone Tree, CO 80124-5534
Phone (303) 790-1800

22 S Adams St
Denver, CO 80209-2908
Phone (303) 321-2452

406 E Grace Ave
Woodland Park, CO 80863-3127
Phone (719) 687-3767

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.65 of 100Reported as group
Quality
92.15
Promoting interoperability
100
Improvement activities
40
Cost
80.02

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.006510COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Apr 27, 2018 Accepting new patients
Denver Health and Hospital Authority CurrentSince Oct 1, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince Oct 1, 2023 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

415 Ray C Hunt Dr
Ste 3100
Charlottesville, VA 22903
Phone (434) 243-3633

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

Interoperability endpoints

  • Direct secure messaging: nralston291444@direct.dhha.org

Organizations & group practices 5

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1523664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1346737483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 172263",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802172263",
            "telephone_number": "888-987-7975",
            "fax_number": "405-792-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST # MC3240",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-436-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Hale Pkwy Ste 330",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802204045",
            "country_code": "US",
            "telephone_number": "472-044-1402",
            "fax_number": "720-360-1195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RALSTON",
        "first_name": "NIKKI",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-14",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.006510",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.