NPIMap

Individual provider Active NPI

Ferougg Khaaliq, PA

  • Medical Physician Assistant
  • Aurora, CO
National Provider Identifier
1790352037
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0006875 Issued in CO
Practice address
1635 Aurora CT
Aurora, CO 80045-2541
Phone
(720) 848-0000
NPI assigned
Jun 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0006875 CO
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X PA.0006875 CO Primary

Addresses

Primary practice location

1635 Aurora CT
Aurora, CO 80045-2541

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

8990 Washington St
Thornton, CO 80229-4537
Phone (720) 929-1655

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
I20221116003323 CO Practitioner - Physician Assistant 7113395484 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

1635 Aurora CT
Aurora, CO 80045-2541
Phone (720) 848-0000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Campesina Family Health Services CurrentSince Aug 5, 2022 Accepting new patients
University Physicians, Incorporated CurrentSince Jan 1, 2023 Accepting new patients
University Physicians Incorporated CurrentSince Jan 1, 2023 Accepting new patients
University Physicians Incorporated Physician Assistant Past Accepting new patients

Locations

1635 Aurora Ct
Fl 4
Aurora, CO 80045
Phone (720) 848-2000

1635 Aurora Ct
Aurora, CO 80045
Phone (720) 848-1060

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

1735 S Public Rd
Lafayette, CO 80026
Phone 30366530361061

1735 S Public Rd
Ste 203
Lafayette, CO 80026

8990 Washington St
Thornton, CO 80229
Phone (720) 929-1655

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1790352037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 AURORA CT",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452541",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8990 Washington St",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802294537",
            "country_code": "US",
            "telephone_number": "720-929-1655",
            "fax_number": "720-565-4129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAALIQ",
        "first_name": "FEROUGG",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006875",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0006875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.