Brooke T Packard, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0002000 Issued in CO

Practice address

4231 W 16TH Ave
Denver, CO 80204-1335

Phone

(303) 629-3721

Fax

(303) 629-2192

NPI assigned

Feb 14, 2006

Last updated

Jan 31, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Brooke Anne Tietsort Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Yampa Valley Medical Center

  • General Acute Care Hospital
  • Steamboat Springs, CO
  • NPI 1790787307
  Medicare reassignment NPD
• Yampa Valley Medical Center

  dba UCHealth Yampa Valley Medical Center

  • Multi-Specialty Clinic/Center
  • Steamboat Springs, CO
  • NPI 1295177426
  NPD
• Yampa Valley Medical Center

  • Pharmacy
  • Steamboat Springs, CO
  • NPI 1861814097
  NPD
• Apex Emergency Group, Inc

  • Emergency Medicine Physician
  • Lakewood, CO
  • NPI 1740231356
  NPD (past)
• Yampa Valley Medical Center

  • Multi-Specialty Clinic/Center
  • Steamboat Springs, CO
  • NPI 1760110571
  NPD (past)

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1770557993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7851 S ELATI ST",
            "address_2": "SUITE 202",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801208080",
            "telephone_number": "303-759-0854",
            "fax_number": "303-759-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4231 W 16TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802041335",
            "telephone_number": "303-629-3721",
            "fax_number": "303-629-2192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2305 Mount Werner Cir # P.027",
            "address_purpose": "LOCATION",
            "city": "Steamboat Springs",
            "state": "CO",
            "postal_code": "804879023",
            "country_code": "US",
            "telephone_number": "970-871-8038",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Mid Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Steamboat Springs",
            "state": "CO",
            "postal_code": "804879006",
            "country_code": "US",
            "telephone_number": "970-870-9770",
            "fax_number": "970-870-9770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACKARD",
        "first_name": "BROOKE",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0002000",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "2000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51026023",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "TIETSORT",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffany Pacheco
• Pacific Home Care/HCBS LLC
• Pacific Limo LLC
• Pacific Respiratory Care Inc. (Colorado Medical Supplies)
• Miguel Paciuc-Beja, M.D
• Jessica Packard
• James Packer, MD
• Deborah Ann Pacuinas, RN
• Cody Padalecki, RN, BSN
• Mary Padalecki, RN

• Physician Assistant in Denver, CO
• Providers in Denver, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.