NPIMap

Individual provider Active NPI

Kaitlin R Regan, PA-C

  • Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1861965402
Registry record updated Dec 16, 2019
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Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone
(970) 493-0112
NPI assigned
Jan 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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 Primary

Addresses

Primary practice location

2500 E Prospect Rd
Fort Collins, CO 80525-9718

Mailing address

2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone (970) 493-0112

Other names 1

  • Ms. Kaitlin R Mommer Former name

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
I20190301000909 CO Practitioner - Physician Assistant 5597004986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic and Spine Center of the Rockies PCGroup PAC ID 0244126365, 145 clinicians

Practice addresses (Care Compare)

1024 S Lemay
Poudre Valley Hospital
Fort Collins, CO 80524-3929
Phone (970) 493-0112

1926 61St Ave
Greeley, CO 80634-8165
Phone (970) 573-3224

2420 E Prospect Rd
Fort Collins MRI
Fort Collins, CO 80525-9718
Phone (970) 493-0567

2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone (970) 493-4010

2500 Rocky Mountain Ave
Loveland, CO 80538-9004
Phone (970) 493-0112

3470 E 15TH St
Loveland, CO 80538-8809
Phone (970) 292-1900

Hospital & facility affiliations

  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010

Merit-based Incentive Payment System (MIPS)

Final score
74.72 of 100Reported as group
Quality
70.39
Promoting interoperability
71
Improvement activities
40
Cost
69.52

National Provider Directory

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

Organizations & group practices 1

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1861965402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E PROSPECT RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259718",
            "telephone_number": "970-493-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E PROSPECT RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259718",
            "telephone_number": "970-493-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAN",
        "first_name": "KAITLIN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "MOMMER",
            "middle_name": "R",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.