Individual provider Active NPI

Clarissa Rachael Flynn, PA

  • Physician Assistant
  • Lakewood, CO
National Provider Identifier
1396345195
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
13795 W Kentucky Dr
Lakewood, CO 80228-3064
Phone
(303) 547-6419
NPI assigned
Oct 29, 2020
Last updated
Oct 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

13795 W Kentucky Dr
Lakewood, CO 80228-3064

Mailing address

13795 W Kentucky Dr
Lakewood, CO 80228-3064
Phone (303) 547-6419

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address crachaelflynn@comcast.net

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210602001219 CO Practitioner - Physician Assistant 9335548916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11600 W 2ND PL
Lakewood, CO 80228-1527
Phone (720) 473-7120

11750 W 2ND PL
Suite 360
Lakewood, CO 80228-1756
Phone (720) 473-7120

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.64 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

National Provider Directory

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

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1396345195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13795 W KENTUCKY DR",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802283064",
            "telephone_number": "303-547-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13795 W KENTUCKY DR",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802283064",
            "telephone_number": "303-547-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "CLARISSA",
        "middle_name": "RACHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crachaelflynn@comcast.net",
            "affiliation": "N",
            "endpointDescription": "Cell",
            "address_1": "13795 W Kentucky Dr",
            "city": "Lakewood",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802283064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.