Erin Manak, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0004690 Issued in CO

Practice address

2101 Main St
Longmont, CO 80501-1406

Phone

(720) 745-8030

Fax

(720) 745-8031

NPI assigned

Jul 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Erin Evenson Former name

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Longs Peak Hospital Hospital, Longmont, CO, CCN 060128

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group NPD
• Uhs of Centennial Peaks LLC

  • Psychiatric Hospital
  • Louisville, CO
  • NPI 1760623888
  Medicare reassignment
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD
• Uhs of Centennial Peaks, LLC

  • Family Nurse Practitioner
  • Louisville, CO
  • NPI 1386179711

  Physician Assistant

  NPD
• Uchealth Community Services

  • Physical Therapist
  • Englewood, CO
  • NPI 1841740693
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Longs Peak Hospital

  • General Acute Care Hospital
  • Longmont, CO
  • NPI 1154876985
  Care Compare affiliation

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1982056719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011406",
            "telephone_number": "720-745-8030",
            "fax_number": "720-745-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011406",
            "telephone_number": "720-745-8030",
            "fax_number": "720-745-8031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2930 11th Ave",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "CO",
            "postal_code": "806201011",
            "country_code": "US",
            "telephone_number": "970-353-9403",
            "fax_number": "970-353-5884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANAK",
        "first_name": "ERIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21175071",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "EVENSON",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Molly Malinski
• Josie Mallinckrodt, DVM
• Amanda Sue Malone, CAC III
• Mark D Malone, PA
• Dawn M Malsom, PAC
• Eric Manchester, PHARMD
• Troy L Manchester, M.D.
• Konoy Mandal, MD
• Tanya Renee Mander, MOT, OTR/L
• Jacquelyn Mannhard

• Physician Assistant in Longmont, CO
• Providers in Longmont, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.