Individual provider Active NPI

Julie Mangelsdorf

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1447738356
Registry record updated Apr 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0005475 Issued in CO
Practice address
777 Bannock St
Denver, CO 80204-4597
Phone
(303) 602-7600
NPI assigned
Aug 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2023

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 PA.0005475 CO Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204-4597

Mailing address

340 Exempla Cir Ste 300
Lafayette, CO 80026-3384

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
I20181113003120 CO Practitioner - Physician Assistant 0840544698 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

340 Exempla Cir
300 Lafayette Clinic Neurosurgery
Lafayette, CO 80026-3384
Phone (303) 673-1390

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

8601 Turnpike Dr
Suite 204
Westminster, CO 80031-7043
Phone (303) 222-4312

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0005475COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Sep 15, 2018 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Feb 13, 2023 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Feb 13, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince Sep 15, 2018 Accepting new patients
Denver Health Past Accepting new patients
Intermountain Medical Group Denver, LLC Past Accepting new patients
Denver Health Medical Center Past Accepting new patients

Locations

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

777 Bannock St
Denver, CO 80204

340 Exempla Cir
Ste 300
Lafayette, CO 80026
Phone (303) 673-1390

Organizations & group practices 7

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 2

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": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681516800000",
    "number": "1447738356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 EXEMPLA CIR STE 300",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-602-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGELSDORF",
        "first_name": "JULIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-02",
        "last_updated": "2023-04-15",
        "certification_date": "2023-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.