NPIMap

Individual provider Active NPI

Anne L. Brockman, M.D.

  • Family Medicine Physician
  • Evergreen, CO
National Provider Identifier
1962455329
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30902 Issued in CO
Practice address
1520 Evergreen Pkwy
Evergreen, CO 80439-7848
Phone
(303) 674-2273
Fax
(303) 670-2160
NPI assigned
May 18, 2006
Last updated
Jan 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30902 CO Primary

Addresses

Primary practice location

1520 Evergreen Pkwy
Evergreen, CO 80439-7848

Mailing address

34 Woodside Cir
Pine, CO 80470-9677
Phone (303) 718-7264

Other identifiers 1

IdentifierTypeStateIssuer
01303020MedicaidCO

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
I20050503001272 CO Practitioner - Family Practice 1658311204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

16280 W 64TH Ave
Adnh Sportsandfamily Arv
Arvada, CO 80007-7413
Phone (720) 898-1110

32214 Ellingwood TRL
210 Evgn Primary Care
Evergreen, CO 80439-9719
Phone (303) 679-2020

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

750 Warner Dr
GDNH Primary Care
Golden, CO 80401-5297
Phone (303) 925-4340

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30902COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Mar 1, 2009 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Mar 1, 2009 Accepting new patients
Big Sky Medicine PC Family Medicine Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Blue Creek Medicine PC Family Medicine Past Accepting new patients

Locations

1520 Evergreen Pkwy
Evergreen, CO 80439
Phone (303) 670-1616

32214 Ellingwood Trl
Ste 210
Evergreen, CO 80439
Phone (303) 679-2020

11700 W 2nd Pl
Ste 210
Lakewood, CO 80228
Phone (720) 321-8080

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 6

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.

Hospital & facility affiliations 11

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1962455329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 WOODSIDE CIR",
            "city": "PINE",
            "state": "CO",
            "postal_code": "804709677",
            "telephone_number": "303-718-7264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 EVERGREEN PKWY",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397848",
            "telephone_number": "303-674-2273",
            "fax_number": "303-670-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "ANNE",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "30902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01303020",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

Verify at the official NPI Registry.