Individual provider Active NPI

Theresa A McDonald, PA-C

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1457628323
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0004989 Issued in CO
Practice address
8101 E Lowry Blvd Ste 230
Denver, CO 80230-7195
Phone
(303) 344-9090
Fax
(303) 344-1922
NPI assigned
Nov 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00272800 NJ
Physician Assistant 363A00000X PA.0004989 CO Primary

Addresses

Primary practice location

8101 E Lowry Blvd Ste 230
Denver, CO 80230-7195

Mailing address

8101 E Lowry Blvd Ste 230
Denver, CO 80230-7195
Phone (303) 344-9090

Other names 1

  • Theresa Moore Former name

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
I20171106001066 CO Practitioner - Physician Assistant 9931375151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
43.24 of 100Reported as group
Quality
73.53
Promoting interoperability
0
Improvement activities
0
Cost
70.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52451CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Centers of Colorado, LLC Physician Assistant CurrentSince Sep 24, 2017 Accepting new patients
Orthopedic Centers of Colorado, LLC Physician Assistant CurrentSince Sep 24, 2017 Accepting new patients

Locations

6235 S Main St
Ste 101
Aurora, CO 80016
Phone (303) 785-7928

6235 S Main St
Ste C101
Aurora, CO 80016

1411 S Potomac St
Ste 350
Aurora, CO 80012
Phone (303) 671-2134

8101 E Lowry Blvd
Ste 230
Denver, CO 80230
Phone (303) 962-3926

8101 E Lowry Blvd
Ste 120
Lowry, CO 80230
Phone (303) 806-1998

11960 Lioness Way
Ste 260
Parker, CO 80134
Phone (303) 214-4500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1457628323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 E LOWRY BLVD STE 230",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307195",
            "telephone_number": "303-344-9090",
            "fax_number": "303-344-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 E LOWRY BLVD STE 230",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307195",
            "telephone_number": "303-344-9090",
            "fax_number": "303-344-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00272800",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "MOORE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.