NPIMap

Individual provider Active NPI

William Kimball Petitt, PA-C

  • Physician Assistant
  • Englewood, CO
National Provider Identifier
1669463055
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1599 Issued in CO
Practice address
799 E Hampden Ave Ste 400
Englewood, CO 80113-2766
Phone
(303) 789-2663
Fax
(303) 788-4871
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA.0001599 CO
Physician Assistant 363A00000X 1599 CO Primary
Medical Physician Assistant 363AM0700X PA.0001599 CO

Addresses

Primary practice location

799 E Hampden Ave Ste 400
Englewood, CO 80113-2766

Mailing address

PO Box 911244
Denver, CO 80291-1244
Phone (888) 269-7001

Other practice location 1

9949 S Oswego St Ste 300
Parker, CO 80134-3888
Phone (303) 925-4750

Other identifiers 1

IdentifierTypeStateIssuer
9000177466MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address WILLIAM.PETITT@hca3.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050816000815 CO Practitioner - Physician Assistant 0840220190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Florida College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portercare Adventist Health SystemGroup PAC ID 0941110886, 770 clinicians

Practice addresses (Care Compare)

2535 S Downing St
Denver, CO 80210-5850
Phone (303) 778-5797

7750 S Broadway
260 South Denver Neurosurgery
Littleton, CO 80122-2623
Phone (303) 734-8650

9395 Crown Crest Blvd
Parker, CO 80138-8573
Phone (303) 269-4975

9949 S Oswego St
200 MRNH Orthopedics
Parker, CO 80134-3753
Phone (303) 925-4750

Hospital & facility affiliations

  • AdventHealth Parker Hospital, Parker, CO, CCN 060114

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
78.58
Promoting interoperability
100
Improvement activities
40
Cost
74.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1599COMDClinical Psychologist
PA.0001599COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Portercare Adventist Health System CurrentSince Jun 27, 2010 Accepting new patients
Portercare Adventist Health System CurrentSince Jun 27, 2010 Accepting new patients
Colorado Orthopedic Specialists Past Accepting new patients
Portercare Adventist Health System Past Accepting new patients

Locations

2535 S Downing St
Ste 100
Denver, CO 80210
Phone (720) 524-1367

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

9949 S Oswego St
Ste 300
Parker, CO 80134
Phone (303) 649-3100

9949 S Oswego St
Ste 200
Parker, CO 80134
Phone (303) 649-3100

Interoperability endpoints

  • Direct secure messaging: william.petitt@hca3.eclinicaldirectplus.com

Organizations & group practices 5

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 6

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1669463055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911244",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802911244",
            "telephone_number": "888-269-7001",
            "fax_number": "303-764-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 E HAMPDEN AVE STE 400",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132766",
            "telephone_number": "303-789-2663",
            "fax_number": "303-788-4871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9949 S Oswego St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801343888",
            "country_code": "US",
            "telephone_number": "303-925-4750",
            "fax_number": "303-925-4751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETITT",
        "first_name": "WILLIAM",
        "middle_name": "KIMBALL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0001599",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1599",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0001599",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000177466",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "WILLIAM.PETITT@hca3.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "799 E Hampden Ave Ste 400",
            "city": "Englewood",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801132766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.