Individual provider Active NPI

Miranda Kortenhoeven, PA

  • Physician Assistant
  • Evans, CO
National Provider Identifier
1841094174
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0009432 Issued in CO
Practice address
2930 11TH Ave
Evans, CO 80620-1011
Phone
(720) 388-4907
NPI assigned
Apr 3, 2025
Last updated
Jan 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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 PA.0009432 CO Primary

Addresses

Primary practice location

2930 11TH Ave
Evans, CO 80620-1011

Mailing address

2930 11TH Ave
Evans, CO 80620-1011
Phone (720) 388-4907

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
I20260130003577 CO Practitioner - Physician Assistant 3971081969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunrise Community HealthGroup PAC ID 0648164780, 51 clinicians

Practice addresses (Care Compare)

2930 11TH Ave
Evans, CO 80620-1011
Phone (970) 353-9403

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0009432COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Community Health CurrentSince Jan 1, 2026 Accepting new patients
Sunrise Community Health CurrentSince Jan 1, 2026 Accepting new patients

Locations

2930 11th Ave
Evans, CO 80620
Phone (970) 350-4606

1010 A St
Greeley, CO 80631
Phone (970) 313-0400

302 3rd St SE
Ste 150
Loveland, CO 80537
Phone (970) 669-4855

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1743638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1841094174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 11TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806201011",
            "telephone_number": "720-388-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 11TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806201011",
            "telephone_number": "720-388-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTENHOEVEN",
        "first_name": "MIRANDA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-03",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0009432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, CO

Sources for this page

Verify at the official NPI Registry.