Individual provider Active NPI

Sara Joan Dieter, PAC

  • Physician Assistant
  • Steamboat Springs, CO
National Provider Identifier
1982610036
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
505 Anglers Dr
Suite 202
Steamboat Springs, CO 80487-8836
Phone
(970) 871-0000
Fax
(970) 870-1400
NPI assigned
Jul 31, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 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 NU Primary

Addresses

Primary practice location

505 Anglers Dr
Suite 202
Steamboat Springs, CO 80487-8836

Mailing address

505 Anglers Dr
Suite 202
Steamboat Springs, CO 80487-8836
Phone (970) 871-0000

Other identifiers 2

IdentifierTypeStateIssuer
1480OtherCOCO STATE LIC
81776535MedicaidCO

Other names 1

  • Sara Joan Bradt Former name

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
I20110516000390 CO Practitioner - Physician Assistant 0547446197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark L. Helm MD PCGroup PAC ID 3678566288, 6 clinicians

Practice addresses (Care Compare)

505 Anglers Dr
Suite 202
Steamboat Springs, CO 80487-8836
Phone (970) 871-0000

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1982610036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 ANGLERS DR",
            "address_2": "SUITE 202",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "804878836",
            "telephone_number": "970-871-0000",
            "fax_number": "970-870-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 ANGLERS DR",
            "address_2": "SUITE 202",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "804878836",
            "telephone_number": "970-871-0000",
            "fax_number": "970-870-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETER",
        "first_name": "SARA",
        "middle_name": "JOAN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO STATE LIC",
            "identifier": "1480",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81776535",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "BRADT",
            "middle_name": "JOAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Steamboat Springs, CO

Sources for this page

Verify at the official NPI Registry.