NPIMap

Individual provider Active NPI

Amanda Welcer, PA-C

  • Surgical Physician Assistant
  • Grand Junction, CO
National Provider Identifier
1356689467
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
2373 G Rd
Suite 100
Grand Junction, CO 81505-9641
Phone
(970) 245-0484
Fax
(970) 242-3087
NPI assigned
Jan 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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 CT Primary
Physician Assistant 363A00000X PA0003722 CO

Addresses

Primary practice location

2373 G Rd
Suite 100
Grand Junction, CO 81505-9641

Mailing address

2373 G Rd
Suite 100
Grand Junction, CO 81505-9641
Phone (970) 245-0484

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
I20131017001289 CO Practitioner - Physician Assistant 5991945974 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

2635 N 7TH St
Grand Junction, CO 81501-8209

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002868CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary's Hospital and Medical Center, Inc CurrentSince Oct 17, 2020 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Family Medicine CurrentSince Jun 6, 2016 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Jun 6, 2016 Accepting new patients
Colorado Surgical Affiliates, LLC CurrentSince Mar 1, 2021 Accepting new patients
St Mary's Hospital and Medical Center, Inc Family Medicine Past Accepting new patients

Locations

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

750 Wellington Ave
Ste 3A
Grand Junction, CO 81501
Phone (970) 248-3188

2440 N 11th St
Grand Junction, CO 81501
Phone (970) 243-0900

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

750 Wellington Ave
Ste 3C
Grand Junction, CO 81501
Phone (970) 243-7908

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1356689467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2373 G RD",
            "address_2": "SUITE 100",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815059641",
            "telephone_number": "970-245-0484",
            "fax_number": "970-242-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 G RD",
            "address_2": "SUITE 100",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815059641",
            "telephone_number": "970-245-0484",
            "fax_number": "970-242-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCER",
        "first_name": "AMANDA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0003722",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.