NPIMap

Individual provider Active NPI

Brett Herbert Whetstine, PA-C

  • Medical Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1376770107
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
TAL2794 Issued in CO
Practice address
4380 Austin Bluffs Pkwy
Colorado Springs, CO 80918-2932
Phone
(719) 454-6010
NPI assigned
Jun 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X TAL2794 CO Primary

Addresses

Primary practice location

4380 Austin Bluffs Pkwy
Colorado Springs, CO 80918-2932

Mailing address

3205 N Academy Blvd
Suite 130
Colorado Springs, CO 80917-5101
Phone (719) 632-5700

Other practice location 1

4863 N Nevada Ave
Second Floor
Colorado Springs, CO 80918-3951
Phone (719) 632-5700

Other identifiers 1

IdentifierTypeStateIssuer
74879031MedicaidCO

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
I20090727000655 CO Practitioner - Physician Assistant 5496808222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Oak Street Health Physicians Group of Colorado PLLCGroup PAC ID 9032585054, 34 clinicians

Practice addresses (Care Compare)

4380 Austin Bluffs Pkwy
Colorado Springs, CO 80918-2932
Phone (719) 454-6010

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022
  • Centura Health-Penrose St Francis Health Services Hospital, Colorado Springs, CO, CCN 060031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TAL2794COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group of Colorado, PLLC Family Medicine CurrentSince Oct 21, 2024 Accepting new patients
Oak Street Health Physicians Group of Colorado, PLLC Family Medicine CurrentSince Oct 21, 2024 Accepting new patients
Peak Vista Community Health Centers CurrentSince Feb 7, 2012 Accepting new patients
Peak Vista Community Health Centers CurrentSince Feb 7, 2012 Accepting new patients
Peak Vista Community Health Centers Past Accepting new patients

Locations

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

4863 N Nevada Ave
Fl Second
Colorado Springs, CO 80918

4380 Austin Bluffs Pkwy
Colorado Springs, CO 80918
Phone (719) 454-6010

4863 N Nevada Ave
Colorado Springs, CO 80918
Phone (719) 255-8001

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1376770107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD",
            "address_2": "SUITE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175101",
            "telephone_number": "719-632-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 AUSTIN BLUFFS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809182932",
            "telephone_number": "719-454-6010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4863 N Nevada Ave",
            "address_2": "Second Floor",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809183951",
            "country_code": "US",
            "telephone_number": "719-632-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHETSTINE",
        "first_name": "BRETT",
        "middle_name": "HERBERT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-19",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "TAL2794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74879031",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.