Individual provider Active NPI

Bailey Moberly, PA-C

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1619288586
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0008911 Issued in CO
Practice address
777 Bannock St
Denver, CO 80204-4597
Phone
(303) 303-4364
Fax
(303) 602-6931
NPI assigned
Jun 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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.0008911 CO Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204-4597

Mailing address

777 Bannock St
Denver, CO 80204-4597
Phone (303) 303-4364

Other practice location 1

1634 Downing St
Denver, CO 80218-1529
Phone (303) 504-1810

Other practice location 2

1500 N Renaissance Blvd NE Ste C
Albuquerque, NM 87107-7002
Phone (505) 266-5565

Other practice location 3

1890 N Revere Ct
Aurora, CO 80045-7464
Phone (303) 724-1000

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
I20250306003669 CO Practitioner - Physician Assistant 5193246130 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Denver Health and Hospital AuthorityGroup PAC ID 4688583578, 830 clinicians

Practice addresses (Care Compare)

777 Bannock St
Denver, CO 80204-4507
Phone (303) 436-6000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Mar 1, 2025 Accepting new patients
University Physicians, Incorporated CurrentSince Mar 7, 2025 Accepting new patients
University Physicians, Incorporated CurrentSince Mar 7, 2025 Accepting new patients
Denver Health and Hospital Authority CurrentSince Mar 1, 2025 Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

1890 N Revere Ct
Ste 4020
Aurora, CO 80045
Phone (303) 724-1000

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

1890 N Revere Ct
Aurora, CO 80045
Phone (303) 724-1000

777 Bannock St
Ste MC3450
Denver, CO 80204

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: bmoberly307035@direct.dhha.org

Organizations & group practices 6

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": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1619288586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-303-4364",
            "fax_number": "303-602-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-303-4364",
            "fax_number": "303-602-6931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1634 Downing St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802181529",
            "country_code": "US",
            "telephone_number": "303-504-1810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 N Renaissance Blvd NE Ste C",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871077002",
            "country_code": "US",
            "telephone_number": "505-266-5565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1890 N Revere Ct",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457464",
            "country_code": "US",
            "telephone_number": "303-724-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOBERLY",
        "first_name": "BAILEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.