Individual provider Active NPI

Matthew Bickelhaupt, PA-C

  • Physician Assistant
  • Thornton, CO
National Provider Identifier
1912559618
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9191 Grant St
Thornton, CO 80229-4361
Phone
(303) 436-2727
Fax
(303) 436-2710
NPI assigned
Jul 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 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 CO Primary

Addresses

Primary practice location

9191 Grant St
Thornton, CO 80229-4361

Mailing address

PO Box 172328
Denver, CO 80217-2328
Phone (800) 962-3303

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
I20191016000662 CO Practitioner - Physician Assistant 0042541492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carepoint Emergency Medicine, PLLCGroup PAC ID 7810291432, 160 clinicians

Practice addresses (Care Compare)

1501 S Potomac St
Medical Center of Aurora
Aurora, CO 80012-5411
Phone (303) 695-2600

9191 Grant St
Thornton, CO 80229-4361
Phone (303) 450-4482

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.

NPI Registry JSON

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1912559618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 172328",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802172328",
            "telephone_number": "800-962-3303",
            "fax_number": "305-929-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 GRANT ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294361",
            "telephone_number": "303-436-2727",
            "fax_number": "303-436-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICKELHAUPT",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.