NPIMap

Timothy Ahearne, PA-C

Individual provider Active NPI Medical Physician Assistant · Aurora, CO

NPI 1396148151 · NPPES record last updated Dec 27, 2018

Key facts

NPI
1396148151
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
PA.0004736 (CO)
Practice address
12605 E 16TH Ave
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Oct 7, 2014
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-005266ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Orthopaedics PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16409/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-005266 IL
Medical Physician Assistant 363AM0700X PA.0004736 CO Yes

Addresses

Primary practice location

12605 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

10103 Ridgegate Pkwy
Suite 112
Lone Tree, CO 80124-5520
Phone (303) 662-8250

Other practice location 1

10103 Ridgegate Pkwy
Suite 112
Lone Tree, CO 80124-5520
Phone (303) 662-8250

Other providers in Aurora, CO

All providers in Aurora, CO · Medical Physician Assistant in Colorado

Sources for this page

Verify at the official NPI Registry.