Individual provider Active NPI

Zach Amdurer

  • Physician Assistant
  • Wheat Ridge, CO
National Provider Identifier
1679008940
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0005019 Issued in CO
Practice address
8550 W 38TH Ave Ste 220
Wheat Ridge, CO 80033-4342
Phone
(303) 403-3670
Fax
(303) 403-6489
NPI assigned
Apr 25, 2017
Last updated
Jun 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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.0005019 CO Primary

Addresses

Primary practice location

8550 W 38TH Ave Ste 220
Wheat Ridge, CO 80033-4342

Mailing address

8550 W 38TH Ave Ste 220
Wheat Ridge, CO 80033-4342
Phone (303) 403-3670

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
I20211214002653 CO Practitioner - Physician Assistant 3375817950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Jun 27, 2022 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jun 27, 2022 Accepting new patients
Intermountain Medical Group Denver, LLC Family Medicine Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

8550 W 38th Ave
Ste 220
Wheat Ridge, CO 80033
Phone (303) 403-3670

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1679008940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 W 38TH AVE STE 220",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334342",
            "telephone_number": "303-403-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 W 38TH AVE STE 220",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334342",
            "telephone_number": "303-403-3670",
            "fax_number": "303-403-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMDURER",
        "first_name": "ZACH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-25",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.