NPIMap

Individual provider Active NPI

Audrey Wondolleck, PA-C

  • Surgical Physician Assistant
  • Aurora, CO
National Provider Identifier
1831932557
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0008659 Issued in CO
Practice address
1635 Aurora CT
Aurora, CO 80045-2541
Phone
(720) 848-0000
NPI assigned
Jun 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X PA.0008659 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

13001 E 17th Pl
Aurora, CO 80045-2570
Phone (303) 724-5000

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
I20240815000474 CO Practitioner - Physician Assistant 9436697927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2121 E Harmony Rd
Unit 330 Uchmg Surgical Spec FC
Fort Collins, CO 80528-3403
Phone (970) 221-5878

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0008659COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jan 26, 2026 Accepting new patients
University Physicians Incorporated CurrentSince Aug 1, 2024 Accepting new patients
University Physicians, Incorporated CurrentSince Aug 1, 2024 Accepting new patients
Poudre Valley Medical Group, LLC Surgery CurrentSince Jan 26, 2026 Accepting new patients
University Physicians Incorporated Surgery Past Accepting new patients

Locations

1635 Aurora Ct
Fl 6
Aurora, CO 80045
Phone (720) 848-2650

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

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

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

11820 Destination Dr
Broomfield, CO 80021
Phone (303) 460-6000

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

2121 E Harmony Rd
Unit 330
Fort Collins, CO 80528
Phone (970) 221-5878

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": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1831932557",
    "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": "13001 E 17th Pl",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452570",
            "country_code": "US",
            "telephone_number": "303-724-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONDOLLECK",
        "first_name": "AUDREY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0008659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.