NPIMap

Individual provider Active NPI

Cynthia Alamedia Mullikin, PA-C

  • Medical Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1730200486
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3058 Issued in CO
Practice address
330 E Laurel St
Fort Collins, CO 80524-3154
Phone
(970) 488-4950
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 534 WY
Surgical Physician Assistant 363AS0400X PA17537 CA
Surgical Physician Assistant 363AS0400X PA2010-0082 NM
Medical Physician Assistant 363AM0700X 3058 CO Primary

Addresses

Primary practice location

330 E Laurel St
Fort Collins, CO 80524-3154

Mailing address

330 E Laurel St
Fort Collins, CO 80524
Phone (970) 488-4950

Other practice location 1

2900 S College Ave Ste 3G
Fort Collins, CO 80525-2562
Phone (970) 300-3323

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
I20140508001647 CO Practitioner - Physician Assistant 1355248279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Northern ColoradoGroup PAC ID 5092176784, 11 clinicians

Practice addresses (Care Compare)

2804 S Timberline Rd
Afc Urgent Care
Fort Collins, CO 80525-2402
Phone (970) 672-4026

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3058COMDMedical Physician Assistant
PA17537CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Youth Medical and Nursing Consultants, Inc CurrentSince Nov 1, 2020 Accepting new patients
Rocky Mountain Youth Medical & Nursing Consultants Inc Physician Assistant PastSince Feb 23, 2020 Accepting new patients
Rocky Mountain Youth Medical and Nursing Consultants, Inc PastSince Nov 22, 2020 Accepting new patients
Dr Karen MD, PLLC Past Accepting new patients

Locations

330 E Laurel St
Fort Collins, CO 80524
Phone (970) 488-4900

Interoperability endpoints

  • Direct secure messaging: cynthia.mullikin.1@14034.direct.athenahealth.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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1730200486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E LAUREL ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80524",
            "telephone_number": "970-488-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E LAUREL ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243154",
            "telephone_number": "970-488-4950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 S College Ave Ste 3G",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805252562",
            "country_code": "US",
            "telephone_number": "970-300-3323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLIKIN",
        "first_name": "CYNTHIA",
        "middle_name": "ALAMEDIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "534",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA17537",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NM",
            "license": "PA2010-0082",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "3058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.