NPIMap

Individual provider Active NPI

Breelyn Ann Wilky, MD

  • Hematology & Oncology Physician
  • Aurora, CO
National Provider Identifier
1861539751
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
DR.0061154 Issued in CO
Practice address
12401 E 17TH Ave
Aurora, CO 80045-2548
Phone
(720) 848-4289
Fax
(720) 848-4293
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME116554 FL
Hematology & Oncology Physician 207RH0003X ME116554 FL
Student in an Organized Health Care Education/Training Program 390200000X
Hematology & Oncology Physician 207RH0003X DR.0061154 CO Primary

Addresses

Primary practice location

12401 E 17TH Ave
Aurora, CO 80045-2548

Mailing address

1475 NW 12TH Ave
Miami, FL 33136-1002
Phone (305) 243-1287

Other practice location 1

1475 NW 12th Ave
Miami, FL 33136-1002
Phone (305) 243-1287

Other identifiers 1

IdentifierTypeStateIssuer
0091872-00MedicaidFL

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
I20181218003271 CO Practitioner - Medical OncologyPractitioner - Internal Medicine 2264612910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Internal Medicine
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0061154COMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated Internal Medicine CurrentSince Nov 1, 2018 Accepting new patients
University Physicians, Incorporated CurrentSince Nov 1, 2018 Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

12401 E 17th Ave
Aurora, CO 80045
Phone (720) 777-8613

1635 Aurora Ct
Fl 3
Aurora, CO 80045
Phone (720) 848-1060

1665 Aurora Ct
Aurora, CO 80045
Phone (303) 724-2066

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

1665 Aurora Ct
Fl 3
Aurora, CO 80045
Phone (303) 493-7245

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

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

Dept 1061
Denver, CO 80256

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 and National Provider Directory roles.

Hospital & facility affiliations 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1861539751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361002",
            "telephone_number": "305-243-1287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 E 17TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452548",
            "telephone_number": "720-848-4289",
            "fax_number": "720-848-4293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1475 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361002",
            "country_code": "US",
            "telephone_number": "305-243-1287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKY",
        "first_name": "BREELYN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME116554",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME116554",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CO",
            "license": "DR.0061154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0091872-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.