Colleen M Shattuck, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1660 Issued in CO

Practice address

6455 S Yosemite St
#600
Greenwood Village, CO 80111-5139

Phone

(303) 710-2013

Fax

(855) 244-2146

NPI assigned

Mar 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO, MT2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

83.75 of 100Reported as group

Quality

71.01

Promoting interoperability

100

Improvement activities

40

Cost

74.84

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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 and National Provider Directory roles.

• St Peter'S Health

  • General Acute Care Hospital
  • Helena, MT
  • NPI 1205025145
  Medicare reassignment NPD (past)
• Rocky Mountain Gastroenterology Associates, PLLC

  • Gastroenterology Physician
  • Lakewood, CO
  • NPI 1669414272
  Medicare reassignment
• St Peter'S Medical Group North

  • Family Medicine Physician
  • Helena, MT
  • NPI 1477844744
  NPD
• St. Peter'S Health

  • Radiology Clinic/Center
  • Butte, MT
  • NPI 1194785154
  NPD

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1376672485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6455 S YOSEMITE ST",
            "address_2": "#600",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801115139",
            "telephone_number": "303-710-2013",
            "fax_number": "855-244-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6455 S YOSEMITE ST",
            "address_2": "#600",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801115139",
            "telephone_number": "303-710-2013",
            "fax_number": "855-244-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHATTUCK",
        "first_name": "COLLEEN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "1660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09738207",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Zelenka Physiotherapy Inc
• Shao Acupuncture&Physical Therapy, Inc
• Shao Natural Healing
• Karen Shappee, RN
• Surit Kumar Sharma, MD
• Anna Shaver
• Samantha Shaw
• Sarah B. Shea, M.S.P.T.
• Stephanie Rose Shea
• Alexandra Klein Shelton, LCSW

• Medical Physician Assistant in Greenwood Village, CO
• Providers in Greenwood Village, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.