Individual provider Active NPI

Anne Elizabeth Gulick, PAC

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1487002671
Registry record updated Jun 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0004689 Issued in CO
Practice address
13123 E 16TH Ave
Aurora, CO 80045-7106
Phone
(720) 777-1234
NPI assigned
May 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2022

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.0004689 CO Primary

Addresses

Primary practice location

13123 E 16TH Ave
Aurora, CO 80045-7106

Mailing address

2055 N High St Ste 370
Denver, CO 80205-5545
Phone (303) 839-6001

Other practice location 1

2055 N High St Ste 370
Denver, CO 80205-5545
Phone (303) 839-6001

Other names 1

  • Anne Elizabeth Dederer Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ANNE.GULICK@hca3.eclinicaldirectplus.com

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
I20160825002082 CO Practitioner - Physician Assistant 5092000398 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0004689COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Youth Medical & Nursing Consultants Inc Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: anne.dederer.1@14034.direct.athenahealth.com
  • Direct secure messaging: anne.gulick@hca3.eclinicaldirectplus.com

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": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654387200000",
    "number": "1487002671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 N HIGH ST STE 370",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055545",
            "telephone_number": "303-839-6001",
            "fax_number": "303-839-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 N High St Ste 370",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802055545",
            "country_code": "US",
            "telephone_number": "303-839-6001",
            "fax_number": "303-839-6033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GULICK",
        "first_name": "ANNE",
        "middle_name": "ELIZABETH",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-27",
        "last_updated": "2022-06-05",
        "certification_date": "2022-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ANNE.GULICK@hca3.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "2055 N High St Ste 370",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802055545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "DEDERER",
            "middle_name": "ELIZABETH",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.