Golda Reisdorph, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0001301 Issued in CO

Practice address

2405 Research Pkwy
Colorado Springs, CO 80920-1044

Phone

(719) 574-9191

NPI assigned

Jun 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

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.

• Optumcare Colorado Medical Group LLC

  • General Practice Physician
  • Colorado Springs, CO
  • NPI 1407252828
  Medicare reassignment NPD (past)
• Optumcare Colorado Medical Group LLC

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1891326161
  NPD
• Optumcare Colorado Medical Group LLC

  • Rheumatology Physician
  • Boulder, CO
  • NPI 1922893478
  NPD
• Front Range Emergency Specialists, PC

  • Emergency Medicine Physician
  • Colorado Springs, CO
  • NPI 1538233234
  NPD (past)
• Mountain View Medical Group, PC

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1295787703

  Medical

  NPD (past)

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1417992132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "719-538-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 RESEARCH PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201044",
            "telephone_number": "719-574-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISDORPH",
        "first_name": "GOLDA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "1301",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0001301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark A. Reinicke, D.D.S
• Mylene Glueckert Reinicke, DDS
• Bryant William Reinking, PA
• Cleo Reinking, MSW
• Reintegrating Life Counseling and Consulting LLC
• Karl Reisig, M.D.
• Michael Anthony Reisig, M.D.
• Patricia Reisinger, LPC
• Kristen E Reiss, PA-C
• Reither Counseling LLC

• Physician Assistant in Colorado Springs, CO
• Providers in Colorado Springs, 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, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.