Heidi Leea Bennett, P.A.-C.
Individual provider Active NPI Physician Assistant · Colorado Springs, CO
NPI 1487756243 · NPPES record last updated Jun 27, 2018
Key facts
- NPI
- 1487756243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA0002477 (CO)
- Practice address
- 3030 N Circle Dr Ste 210
Colorado Springs, CO 80909 - Phone
- (719) 228-9440
- Fax
- (719) 228-9061
- NPI assigned
- Sep 2, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Colorado Springs Interventional Pain Management PC
Select Physical Therapy of Colorado Springs LP
Practice addresses (Care Compare)
3030 N Circle Dr
Suite 210
Colorado SPGS, CO 80909-1180
Phone (719) 228-9440
5825 Delmonico Dr
Colorado Springs, CO 80919-2243
Phone (719) 257-4240
Hospital & facility affiliations
- Uchealth Pikes Peak Regional Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
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 |
|---|---|---|---|---|
| I20090210000764 | CO | Practitioner - Physician Assistant | 7517022387 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA0002477 | CO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain View Medical Group, PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA0002477 | CO | Yes |
Addresses
Primary practice location
3030 N Circle Dr Ste 210
Colorado Springs, CO 80909
Mailing address
PO Box 4659
San Luis Obispo, CA 93403-4659
Phone (805) 544-7246
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58821031 | Medicaid | CO |
Other names
- Heidi Hull
Other providers in Colorado Springs, CO
- Bennett Medical Services
- Carol Jean Bennett
- Cedar Wray Bennett
- Cedrice Bennett
- Daniel Bennett
- Mackenna Bennett
- Mariah Lynn Bennett
- Mark Daniel Bennett
- Michelle Bennett
- Philip R Bennett
All providers in Colorado Springs, 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 Jun 27, 2018. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.