NPIMap

Individual provider Active NPI

Michelle Simonsson, PA-C

  • Physician Assistant
  • Greeley, CO
National Provider Identifier
1841262136
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1332 Issued in CO
Practice address
1900 16TH St
Greeley, CO 80631-5114
Phone
(970) 350-2427
Fax
(970) 350-2421
NPI assigned
Feb 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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 1332 CO Primary

Addresses

Primary practice location

1900 16TH St
Greeley, CO 80631-5114

Mailing address

1900 16TH St
Greeley, CO 80631-5114
Phone (970) 350-2427

Other identifiers 1

IdentifierTypeStateIssuer
P00944819OtherCOMEDICARE RAILROAD CARRIER PTAN

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
I20100106000697 CO Practitioner - Physician Assistant 4688715139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2000
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)

1024 S Lemay Ave
Fort Collins, CO 80524-3929

221 E 29TH St
Loveland, CO 80538-2746

2315 E Harmony Rd
Fort Collins, CO 80528-8620

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1332COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Oct 13, 2010 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients

Locations

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

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2315 E Harmony Rd
Ste 160
Fort Collins, CO 80528
Phone (970) 493-8800

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

6767 29th St
Ste 2
Greeley, CO 80634

1900 16th St
Greeley, CO 80631
Phone (970) 350-2438

2500 Rocky Mountain Ave
Ste 2200
Loveland, CO 80538
Phone (970) 203-7250

2500 Rocky Mountain Ave
Ste 310
Loveland, CO 80538
Phone (866) 697-5337

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

221 E 29th St
Ste 102
Loveland, CO 80538
Phone (970) 224-3636

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.

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1841262136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315114",
            "telephone_number": "970-350-2427",
            "fax_number": "970-350-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315114",
            "telephone_number": "970-350-2427",
            "fax_number": "970-350-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONSSON",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER PTAN",
            "identifier": "P00944819",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.