NPIMap

Individual provider Active NPI

Brian Cronk, PA-C

  • Medical Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1760583785
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
643 Issued in CO
Practice address
3702 S Timberline Rd
Fort Collins, CO 80525-3624
Phone
(970) 207-9773
Fax
(970) 207-1893
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 643 CO Primary

Addresses

Primary practice location

3702 S Timberline Rd
Fort Collins, CO 80525-3624

Mailing address

3702 S Timberline Rd
Fort Collins, CO 80525-3624
Phone (970) 207-9773

Other identifiers 1

IdentifierTypeStateIssuer
002402359MedicaidCO

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
I20070816000026 CO Practitioner - Physician Assistant 8628160900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centers for GastroenterologyGroup PAC ID 9537059555, 38 clinicians

Practice addresses (Care Compare)

3702 S Timberline Rd
Suite a
Fort Collins, CO 80525-3625
Phone (970) 207-9773

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
60.52 of 100Reported as group
Quality
0
Promoting interoperability
100
Improvement activities
40
Cost
68.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
643COMDAudiologist-Hearing Aid Fitter

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 and National Provider Directory roles.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1760583785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 S TIMBERLINE RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253624",
            "telephone_number": "970-207-9773",
            "fax_number": "970-207-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 S TIMBERLINE RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253624",
            "telephone_number": "970-207-9773",
            "fax_number": "970-207-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRONK",
        "first_name": "BRIAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002402359",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.