Julianne Doherty, PA
Individual provider Active NPI Physician Assistant · Aurora, CO
NPI 1457407397 · NPPES record last updated Jan 4, 2011
Key facts
- NPI
- 1457407397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2123 (CO)
- Practice address
- 13123 E 16TH Ave
Aurora, CO 80045-7106 - Phone
- (720) 777-1234
- NPI assigned
- Jan 25, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070314000325 | CO | Practitioner - Physician Assistant | 0345343240 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2123 | CO | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathology Assoc of the Roaring Fork | Current | Accepting new patients | |
| Valley View Hospital Association | Current | Accepting new patients | |
| Valley View Hospital Association | Current |
Accepting new patients | |
| Valley View Hospital Association | Current |
Accepting new patients | |
| University Physicians Incorporated | Physician Assistant | Past | Accepting new patients |
| Valley View Hospital Association | Past | Accepting new patients |
Locations
1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033
1830 Blake Ave
Ste 101
Glenwood Springs, CO 81601
Phone (970) 384-7144
Interoperability endpoints
- julianne.doherty.1@14940.direct.athenahealth.com
- julianne.doherty.1@9028.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2123 | CO | Yes |
Addresses
Primary practice location
13123 E 16TH Ave
Aurora, CO 80045-7106
Mailing address
PO Box 876
Aurora, CO 80040-0876
Phone (303) 493-7000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13973541 | Medicaid | CO |
Other providers in Aurora, CO
- Matthew Doerfler
- Richard C Doerhoff
- Catherine Doernbrack
- Abigail Patricia Doherty
- Courtney Doherty
- Kevin James Doherty
- Christine Marie Doidge
- Ella Lee Dolan
- Jacob Dolan
- Michaela Dolan
All providers in Aurora, CO · Physician Assistant in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.