Brian D Holmgren, PA
Individual provider Active NPI Physician Assistant · Lakewood, CO
NPI 1659622256 · NPPES record last updated Aug 15, 2013
Key facts
- NPI
- 1659622256
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 3547 (CO)
- Practice address
- 11600 W 2ND PL
Lakewood, CO 80228-1527 - Phone
- (720) 321-4161
- Fax
- (720) 321-4165
- NPI assigned
- Sep 24, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 28
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rawlins County Health Center
Perkins County Hospital District
Practice addresses (Care Compare)
707 Grant St
Atwood, KS 67730-1526
Phone 78562632112205
900 Lincoln Ave
Grant, NE 69140-3095
Phone (308) 352-7200
Hospital & facility affiliations
- L & C Home Health Agency Inc
- Rawlins County Health Center
- Perkins County Health Services
- Citizens Medical Center
- Rawlins County Health Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in CO, NE, KS
- 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 |
|---|---|---|---|---|
| I20121005000634 | CO | Practitioner - Physician Assistant | 5890944847 | Reassigns benefits to 5 organizations |
| I20171002001339 | NE | Practitioner - Physician Assistant | 5890944847 | Reassigns benefits to 2 organizations |
| I20201203002938 | KS | Practitioner - Physician Assistant | 5890944847 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3547 | CO | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rawlins County Health Center | Current | Accepting new patients | |
| Usacs of Colorado Inc | Current |
Accepting new patients | |
| Goodland Regional Medical Center | Current |
Accepting new patients | |
| Perkins County Hospital District | Current |
Accepting new patients | |
| Emergency Service Physicians, Inc. | Current |
Accepting new patients | |
| Rawlins County Health Center | Current |
Accepting new patients | |
| Perkins County Hospital District | Current |
Accepting new patients | |
| Rawlins County Health Center | Current |
Accepting new patients | |
| Premier Emergency Services, Inc | Current |
Accepting new patients | |
| Emergency Service Physicians, Inc. | Current |
Accepting new patients | |
| Usacs Observation Medicine Services of Colorado, Inc. | Current |
Accepting new patients | |
| Perkins County Hospital District | Current |
Accepting new patients | |
| Goodland Regional Medical Center | Current |
Accepting new patients | |
| Usacs Community Emergency Services of Colorado, Inc. | Current |
Accepting new patients | |
| Usacs of Colorado Inc | Current |
Accepting new patients | |
| Usacs Observation Medicine Services of Colorado Inc. | Current |
Accepting new patients | |
| Apex Emergency Group, Inc | Past | Accepting new patients | |
| Goodland Regional Medical Center | Past | Accepting new patients |
Locations
7000 E Hampden Ave
Denver, CO 80224
Phone (330) 925-4199
11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-1010
7700 S Broadway
Littleton, CO 80122
Phone (303) 269-4786
2551 W 84th Ave
Westminster, CO 80031
Phone (303) 202-1280
8300 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 425-2015
707 Grant St
Atwood, KS 67730
Phone (785) 626-3211
106 Willow Rd
Goodland, KS 67735
Phone (785) 890-6012
900 Lincoln Ave
Grant, NE 69140
Phone (308) 352-7200
Interoperability endpoints
- https://api.platform.athenahealth.com/13372/brand/1/csg/1/fhir/r4
- brian.holmgren.1@13372.direct.athenahealth.com
- brian.holmgren.1@17074.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3547 | CO | Yes |
Addresses
Primary practice location
11600 W 2ND PL
Lakewood, CO 80228-1527
Mailing address
PO Box 5788
Denver, CO 80217-5788
Phone (303) 202-1280
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01884859 | Medicaid | CO |
Other providers in Lakewood, CO
- Lorraine Estelle Holly
- Patrick Holmbo
- Elisha Holmes
- Giselle Holmes
- Laura Kaitlin Holmes
- Melinda Holt
- Stanley Dean Holveck
- Hometown Neurodiagnostics-Colorado LLC
- Dustin Homicki
- Kristin Ann Honaman
All providers in Lakewood, 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 Aug 15, 2013. 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.