NPIMap

Individual provider Active NPI

Mark R Speckman, NP

  • Adult Health Nurse Practitioner
  • Aurora, CO
National Provider Identifier
1851621171
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APN.0010054-NP Issued in CO
Practice address
12605 E 16TH Ave
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Jan 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP-10054 CO
Adult Health Nurse Practitioner 363LA2200X APN.0010054-NP CO Primary

Addresses

Primary practice location

12605 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

3400 Youngfield St
Wheat Ridge, CO 80033-5245
Phone (303) 459-5645

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
I20211116001005 CO Practitioner - Nurse Practitioner 8123343357 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

12605 E 16TH Ave
Uchealth Anschutz Medical Campus
Aurora, CO 80045-2545
Phone (720) 848-0000

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-10054COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince Apr 15, 2024 Accepting new patients
Artemis Healthcare Services LLC CurrentSince Jan 3, 2023 Accepting new patients
University Physicians, Incorporated CurrentSince Apr 15, 2024 Accepting new patients
University Physicians Incorporated Nurse Practitioner Current Accepting new patients
The Little Clinic of Colorado, LLC Family CurrentSince Oct 31, 2022 Accepting new patients
Agape Palliative Services, LLC PastSince Jan 3, 2023 Accepting new patients

Locations

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

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

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

Dept 1061
Denver, CO 80256

6041 S Syracuse Way
Ste 220
Greenwood Village, CO 80111
Phone (720) 482-1988

7984 W Alameda Ave
Lakewood, CO 80226
Phone (303) 459-7105

10101 Ridgegate Pkwy
Lone Tree, CO 80124
Phone (720) 225-1000

3400 Youngfield St
Wheat Ridge, CO 80033
Phone (303) 238-7301

Interoperability endpoints

  • Direct secure messaging: mark.speckman@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 6

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1851621171",
    "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": "12605 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Youngfield St",
            "address_purpose": "LOCATION",
            "city": "Wheat Ridge",
            "state": "CO",
            "postal_code": "800335245",
            "country_code": "US",
            "telephone_number": "303-459-5645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPECKMAN",
        "first_name": "MARK",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-08",
        "last_updated": "2024-03-25",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "NP-10054",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "APN.0010054-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.