Gabriel Hollist, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

1360 S Potomac St
Aurora, CO 80012-4505

Phone

(303) 337-5575

NPI assigned

Dec 4, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Mauricio Waintrub, M.D., P.C

  dba Rocky Mountain Internal Medicine

  • Internal Medicine Physician
  • Aurora, CO
  • NPI 1336172774
  Medicare reassignment

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1568977247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 S POTOMAC ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124505",
            "telephone_number": "303-337-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 S POTOMAC ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124505",
            "telephone_number": "303-337-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIST",
        "first_name": "GABRIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO MEDICAL BOARD",
            "identifier": "PA.000521",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haylee Hollifield, M.S., CCC-SLP
• Amanda Holliman
• Shawn Hollinger, M.D.
• Colette Hollingsworth
• Amanda Hollis
• John Roger Hollister, MD
• Deborah Cannon Holloway, RN, BSN
• Jennifer Ann Holloway, RN
• Myoung Ah Holm, PSY
• Martha Alexandra Holman

• Medical Physician Assistant in Aurora, CO
• Providers in Aurora, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.