Cheryl Lynn Liedtke, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0004488 Issued in CO

Practice address

2450 S Peoria St Ste 245
Aurora, CO 80014

Phone

(303) 752-7732

NPI assigned

Aug 7, 2006

Last updated

Feb 5, 2019By 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 3

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

Practice roles

Locations

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.

• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group
• True North Health Navigation LLC

  dba Dispatch Health

  • Emergency Medicine Physician
  • Denver, CO
  • NPI 1740622133
  Medicare reassignment NPD
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD
• Mark. B. Lonstein M.D.P.a.

  • Orthopaedic Surgery Physician
  • Sarasota, FL
  • NPI 1609826734
  NPD (past)

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1376552281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4451",
            "fax_number": "970-490-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 S PEORIA ST STE 245",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80014",
            "telephone_number": "303-752-7732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9908 S.R. 64 East",
            "address_2": "Lakewood Ranch Urgent Care",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "34212",
            "country_code": "US",
            "telephone_number": "941-747-8600",
            "fax_number": "941-749-5915",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3455 Ringsby Court",
            "address_2": "Unit 102",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802168021",
            "country_code": "US",
            "telephone_number": "303-500-1518",
            "fax_number": "720-598-0440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEDTKE",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101925",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004488",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9101925",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000169533",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Leigh Lichtenberg
• Ashley Licursi, PA-C
• Arleen Liddell
• Delaney Liebbe, CAA
• Phillip Maxwell Lieberman
• Kendra Marie Liedtke, MSW, LCSW
• Tristan Lien, AU.D., CCC-A
• Christopher Lieu, MD
• Devin Lieu, RPH
• Life Adult Day Care LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.