Individual provider Active NPI

Amanda Marie Buchholz, PA-C

  • Physician Assistant
  • Littleton, CO
National Provider Identifier
1972865715
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0004276 Issued in CO
Practice address
13402 W Coal Mine Ave Ste 110
Littleton, CO 80127-5408
Phone
(719) 540-2146
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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 PA.0004276 CO Primary

Addresses

Primary practice location

13402 W Coal Mine Ave Ste 110
Littleton, CO 80127-5408

Mailing address

2860 S Circle Dr Ste 109
Colorado Springs, CO 80906-4195
Phone (719) 540-2146

Other practice location 1

1650 Cochrane Cir
Ft Carson, CO 80913-4613
Phone (719) 526-7000

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
I20190531000271 CO Practitioner - Physician Assistant 9830422146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

2860 S Circle Dr
Colorado Springs, CO 80906-4195
Phone (719) 540-2100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0004276COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC CurrentSince Apr 25, 2022 Accepting new patients
Family Care Center, LLC Physician Assistant CurrentSince Apr 25, 2022 Accepting new patients

Locations

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

13402 W Coal Mine Ave
Ste 110
Littleton, CO 80127
Phone (303) 248-7894

10120 Twenty Mile Rd
Ste 100
Parker, CO 80134
Phone (303) 228-8871

Organizations & group practices 2

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": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1972865715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 S CIRCLE DR STE 109",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064195",
            "telephone_number": "719-540-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13402 W COAL MINE AVE STE 110",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801275408",
            "telephone_number": "719-540-2146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Cochrane Cir",
            "address_purpose": "LOCATION",
            "city": "Ft Carson",
            "state": "CO",
            "postal_code": "809134613",
            "country_code": "US",
            "telephone_number": "719-526-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCHHOLZ",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.