Brock T Reichert

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0005024 Issued in CO

Practice address

1024 S Lemay Ave
Fort Collins, CO 80524-3929

Phone

(970) 495-7000

Fax

(303) 306-7753

NPI assigned

May 31, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Brock T Reichert Professional name

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

Merit-based Incentive Payment System (MIPS)

Final score

93.04 of 100Reported as group

Quality

87.35

Promoting interoperability

100

Improvement activities

40

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.

• Emergency Physicians of the Rockies, PC

  • Emergency Medicine Physician
  • Ft Collins, CO
  • NPI 1174570717
  Medicare reassignment NPD

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1457798498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912215",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802912215",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 S LEMAY AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243929",
            "telephone_number": "970-495-7000",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICHERT",
        "first_name": "BROCK",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-31",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08630",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325267801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROCK",
            "last_name": "REICHERT",
            "middle_name": "T",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nancy Marie Reges, ANP-C
• Regina Hariri LPC, LLC
• Rehab Barre PLLC
• Hannah Reich
• Nicole Reichelderfer
• Timothy Reichner, LPC
• Alison Reid
• Courtney Reid
• Crista Reid, MA, LPCC
• James Joseph Reid, LCSW

• Physician Assistant in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.