Individual provider Active NPI

Adam Edward Peindl, PA

  • Surgical Physician Assistant
  • Grand Junction, CO
National Provider Identifier
1639817612
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0007437 Issued in CO
Practice address
627 25 1/2 Rd
Grand Junction, CO 81505-6401
Phone
(970) 242-3535
Fax
(970) 683-2745
NPI assigned
May 20, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA.0007437 CO Primary

Addresses

Primary practice location

627 25 1/2 Rd
Grand Junction, CO 81505-6401

Mailing address

627 25 1/2 Rd
Grand Junction, CO 81505-6401
Phone (970) 242-3535

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
I20220802000056 CO Practitioner - Physician Assistant 3779965140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

2635 N 7TH St
Grand Junction, CO 81501-8209

627 25
Grand Junction, CO 81505-6401
Phone (970) 242-3535

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0007437COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Aug 29, 2022 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Aug 29, 2022 Accepting new patients
St Mary's Hospital and Medical Center, Inc Past Accepting new patients

Locations

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639817612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 25 1/2 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815056401",
            "telephone_number": "970-242-3535",
            "fax_number": "970-683-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 25 1/2 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815056401",
            "telephone_number": "970-242-3535",
            "fax_number": "970-683-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEINDL",
        "first_name": "ADAM",
        "middle_name": "EDWARD",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0007437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.