Individual provider Active NPI

Denver H Hager, PA-C

  • Physician Assistant
  • Palmer Lake, CO
National Provider Identifier
1568449668
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1063 Issued in CO
Practice address
88 Highway 105
Palmer Lake, CO 80133-9045
Phone
(719) 419-8002
Fax
(719) 419-8003
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 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 1063 CO Primary

Addresses

Primary practice location

88 Highway 105
Palmer Lake, CO 80133-9045

Mailing address

506 Ridge Rd
Divide, CO 80814-9635
Phone (719) 332-3097

Other identifiers 1

IdentifierTypeStateIssuer
18424058MedicaidCO

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
I20061108000415 CO Practitioner - Physician Assistant 7315944139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Achieve Whole Recovery, PCGroup PAC ID 8123388527, 23 clinicians

Practice addresses (Care Compare)

1115 Elkton Dr
Suite 300
Colorado Springs, CO 80907-3597
Phone (719) 373-9703

1905 N Sherman St
Suite 900
Denver, CO 80203-1130
Phone (719) 373-9703

8380 Zuni St
Suite 305
Denver, CO 80221-4689
Phone (719) 373-9703

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1063COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Whole Recovery, PC CurrentSince Jul 18, 2022 Accepting new patients
Achieve Whole Recovery, PC CurrentSince Jul 18, 2022 Accepting new patients

Locations

1115 Elkton Dr
Ste 300
Colorado Springs, CO 80907
Phone (719) 357-6471

1905 N Sherman St
Ste 900
Denver, CO 80203
Phone (303) 749-5150

8380 Zuni St
Ste 305
Westminster, CO 80221
Phone (719) 357-6471

Interoperability endpoints

  • Direct secure messaging: denver@4dfd50d0.micromddirect.com

Organizations & group practices 3

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1568449668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 RIDGE RD",
            "city": "DIVIDE",
            "state": "CO",
            "postal_code": "808149635",
            "telephone_number": "719-332-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 HIGHWAY 105",
            "city": "PALMER LAKE",
            "state": "CO",
            "postal_code": "801339045",
            "telephone_number": "719-419-8002",
            "fax_number": "719-419-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGER",
        "first_name": "DENVER",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18424058",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer Lake, CO

Sources for this page

Verify at the official NPI Registry.