NPIMap

Individual provider Active NPI

Charles Nemejc, PA

  • Physician Assistant
  • Greeley, CO
National Provider Identifier
1932132644
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1184 Issued in CO
Practice address
1801 16TH St
Greeley, CO 80631-5154
Phone
(970) 679-9349
NPI assigned
Jul 8, 2006
Last updated
May 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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 1184 CO Primary

Addresses

Primary practice location

1801 16TH St
Greeley, CO 80631-5154

Mailing address

PO Box 337420
Greeley, CO 80633-0624

Other practice location 1

1820 58th Ave Ste 110
Vero Beach, FL 32966-4675
Phone (772) 257-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, CA, FL3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050902000522 CO Practitioner - Physician Assistant 7113959784 Reassigns benefits to 1 organization
I20161212001710 CA Practitioner - Physician Assistant 7113959784 Reassigns benefits to 3 organizations
I20231030001216 FL Practitioner - Physician Assistant 7113959784 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hma-Solantic Joint Venture LLCGroup PAC ID 6002955788, 8 clinicians
Solantic/South Florida LLCGroup PAC ID 5496762171, 27 clinicians

Practice addresses (Care Compare)

1820 58TH Ave
Suite 110
Vero Beach, FL 32966-4675
Phone (772) 257-3200

784 E Prima Vista Blvd
Port St Lucie, FL 34952-2271
Phone (772) 878-7311

9035 Pines Blvd
Pembroke Pines, FL 33024-6440
Phone (954) 378-0333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1184COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Colorado, PC Physician Assistant CurrentSince Sep 1, 2015 Accepting new patients
North Colorado Emergency Physicians, PC Current Accepting new patients
Emerald Orthopaedics, PC Past Accepting new patients
Quantum Plus LLC Physician Assistant Past Accepting new patients
Banner Medical Group Greeley LLC Past Accepting new patients
North Colorado Medical Center Past Accepting new patients
Big Thompson Medical Group Inc Physician Assistant Past Accepting new patients

Locations

5000 Hopyard Rd
Ste 100
Pleasanton, CA 94588
Phone (480) 861-4015

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

2000 Boise Ave
Loveland, CO 80538
Phone (970) 635-4071

615 Fairhurst St
Sterling, CO 80751
Phone (970) 521-0322

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1932132644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337420",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806330624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315154",
            "telephone_number": "970-679-9349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1820 58th Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329664675",
            "country_code": "US",
            "telephone_number": "772-257-3200",
            "fax_number": "772-257-0187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEMEJC",
        "first_name": "CHARLES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.