Individual provider Active NPI

Avery Sheiner, PA-C

  • Dermatology Physician
  • Castle Rock, CO
National Provider Identifier
1679292080
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0008723 Issued in CO
Practice address
4350 Limelight Ave # 205
Castle Rock, CO 80109-8034
Phone
(303) 524-5112
NPI assigned
Aug 26, 2022
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Dermatology Physician 207N00000X 0008723 CO Primary

Addresses

Primary practice location

4350 Limelight Ave # 205
Castle Rock, CO 80109-8034

Mailing address

4350 Limelight Ave Ste 205
Castle Rock, CO 80109-8034
Phone (720) 686-7546

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
I20241017003685 CO Practitioner - Physician Assistant 7911439716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarity Dermatology PLLCGroup PAC ID 4789942525, 12 clinicians

Practice addresses (Care Compare)

4350 Limelight Ave
Suite 205
Castle Rock, CO 80109-8034
Phone (720) 686-7546

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0008723COMDDermatology Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1679292080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 LIMELIGHT AVE STE 205",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801098034",
            "telephone_number": "720-686-7546",
            "fax_number": "720-686-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 LIMELIGHT AVE # 205",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801098034",
            "telephone_number": "303-524-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEINER",
        "first_name": "AVERY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-26",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "0008723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

Verify at the official NPI Registry.