Individual provider Active NPI

Kristin E Pogue, PA-C

  • Physician Assistant
  • Durango, CO
National Provider Identifier
1861564122
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2299 Issued in CO
Practice address
523 S Camino del Rio Ste B
Durango, CO 81303-6853
Phone
(970) 247-1970
Fax
(970) 259-1668
NPI assigned
Nov 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PA2299 CO Primary

Addresses

Primary practice location

523 S Camino del Rio Ste B
Durango, CO 81303-6853

Mailing address

PO Box 2299
Durango, CO 81302-2299
Phone (970) 247-1970

Other identifiers 1

IdentifierTypeStateIssuer
PA2299OtherCOSTATE LICENSE

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
I20070214000167 CO Practitioner - Physician Assistant 1254333636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Durango Dermatology and Dermatologic Surgery LLCGroup PAC ID 1153375902, 9 clinicians

Practice addresses (Care Compare)

523 S Camino del Rio
Suite B
Durango, CO 81303-6853
Phone (970) 247-1970

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2299COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Durango Dermatology and Dermatologic Surgery LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861564122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2299",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813022299",
            "telephone_number": "970-247-1970",
            "fax_number": "970-259-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 S CAMINO DEL RIO STE B",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813036853",
            "telephone_number": "970-247-1970",
            "fax_number": "970-259-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POGUE",
        "first_name": "KRISTIN",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA2299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA2299",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.