Individual provider Active NPI

Bridget Eileen Forsmark, P.A.-C.

  • Medical Physician Assistant
  • Lakewood, CO
National Provider Identifier
1891021945
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2837 Issued in CO
Practice address
1805 Kipling St.
Lakewood, CO 80215
Phone
(303) 422-3727
Fax
(303) 467-9354
NPI assigned
Oct 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2837 CO Primary

Addresses

Primary practice location

1805 Kipling St.
Lakewood, CO 80215

Mailing address

477 Whitetail Cir
Lafayette, CO 80026-9067
Phone (720) 389-8066

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
I20100803001322 CO Practitioner - Physician Assistant 5395878920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medicine Assoc. of Wheat Ridge, P.C.Group PAC ID 8325014053, 5 clinicians

Practice addresses (Care Compare)

1805 Kipling St
Lakewood, CO 80215-2873
Phone 303422372728

Hospital & facility affiliations

  • Intermountain Health Lutheran Hospital Hospital, Wheat Ridge, CO, CCN 060009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2837COMDSports Physician Chiropractor

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 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": "1256428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1891021945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 WHITETAIL CIR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800269067",
            "telephone_number": "720-389-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 KIPLING ST.",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "80215",
            "telephone_number": "303-422-3727",
            "fax_number": "303-467-9354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSMARK",
        "first_name": "BRIDGET",
        "middle_name": "EILEEN",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-25",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.