Individual provider Active NPI

Juliana Schrettner, PA

  • Physician Assistant
  • Pueblo, CO
National Provider Identifier
1932217635
Registry record updated Dec 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
694 Issued in CO
Practice address
1600 N Greenwood
520
Pueblo, CO 81003
Phone
(719) 543-0909
Fax
(719) 543-0006
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2016

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 694 CO Primary

Addresses

Primary practice location

1600 N Greenwood
520
Pueblo, CO 81003

Mailing address

400 N Main St
Pueblo, CO 81003-3123
Phone (719) 584-4400

Other identifiers 2

IdentifierTypeStateIssuer
841541697OtherCOUNITED HEALTH
841541697OtherCOBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170929002669 CA Practitioner - Physician Assistant 6103919378 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
694COMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lodi Memorial Hospital Association Inc CurrentSince Sep 1, 2017 Accepting new patients
Lodi Memorial Hospital Association Inc CurrentSince Sep 1, 2017 Accepting new patients

Locations

2415 W Vine St
Ste 105
Lodi, CA 95242
Phone (209) 333-3121

801 S Ham Ln
Ste S
Lodi, CA 95242
Phone (209) 333-8066

Interoperability endpoints

  • Direct secure messaging: jschrettner140667@ehr.johnmuirhealth.com

Organizations & group practices 3

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1932217635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N MAIN ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033123",
            "telephone_number": "719-584-4400",
            "fax_number": "719-543-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N GREENWOOD",
            "address_2": "520",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81003",
            "telephone_number": "719-543-0909",
            "fax_number": "719-543-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRETTNER",
        "first_name": "JULIANA",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "841541697",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "841541697",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.