Individual provider Active NPI

Sheila M Sullivan, PA-C

  • Physician Assistant
  • Golden, CO
National Provider Identifier
1790747582
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1606 Issued in CO
Practice address
660 Golden Ridge Rd
Ste 250
Golden, CO 80401-9541
Phone
(303) 233-1223
Fax
(303) 233-8755
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1606 CO Primary

Addresses

Primary practice location

660 Golden Ridge Rd
Ste 250
Golden, CO 80401-9541

Mailing address

660 Golden Ridge Rd
Ste 250
Golden, CO 80401-9541
Phone (303) 233-1223

Other identifiers 1

IdentifierTypeStateIssuer
30035031MedicaidCO

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
I20110425000509 CO Practitioner - Physician Assistant 1850576414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Colorado School of Medicine, Denver, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Panorama Orthopedics and Spine Center PCGroup PAC ID 8426961087, 316 clinicians

Practice addresses (Care Compare)

660 Golden Ridge Rd
Golden, CO 80401-9541

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1606COMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Panorama Orthopedics & Spine Center, PC CurrentSince Jul 22, 2002 Accepting new patients
Panorama Orthopedics and Spine Center PC Physician Assistant CurrentSince Jul 22, 2002 Accepting new patients

Locations

660 Golden Ridge Rd
Ste 250
Golden, CO 80401
Phone (303) 274-7321

640 Plaza Dr
Ste 130
Highlands Ranch, CO 80129

1060 Plaza Dr
Ste 200
Highlands Ranch, CO 80129

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1790747582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 GOLDEN RIDGE RD",
            "address_2": "STE 250",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804019541",
            "telephone_number": "303-233-1223",
            "fax_number": "303-233-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 GOLDEN RIDGE RD",
            "address_2": "STE 250",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804019541",
            "telephone_number": "303-233-1223",
            "fax_number": "303-233-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SHEILA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30035031",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden, CO

Sources for this page

Verify at the official NPI Registry.