KAREN L BERTASSO (NPI# 1003110412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003110412 |
| Entity Type | Individual |
| Full Name | KAREN L BERTASSO |
| Credential | PA |
| Practice Address |
1107 S Lemay Ave Ste 240 Fort Collins CO 80524-3960 |
| Practice Telephone | 9704957421 |
| Practice Fax Number | 9704957424 |
| Mailing Telephone | 9704957421 |
| Mailing Fax Number | 9704957424 |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2014-01-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA.0003582 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
014616 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 64429270 | 05 |
| Street Address |
1107 S LEMAY AVE STE 240 |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80524-3960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720089014 | Philip N. Priebe | Obstetrics & Gynecology | 1107 S Lemay Ave, Suite 300, Fort Collins, CO 80524-3957 | 2005-08-09 |
| 1649871880 | Poudre Valley Medical Group, LLC | Internal Medicine | 1107 S Lemay Ave, Fort Collins, CO 80524-3960 | 2020-11-04 |
| 1811372857 | Kimberly Ann Perez | Advanced Practice Midwife | 1107 S Lemay Ave, Suite 300, Fort Collins, CO 80524-3960 | 2015-07-20 |
| 1073938783 | Kristin Glenn | Lactation Consultant, Non-RN | 1107 S Lemay Ave, Suite 300, Fort Collins, CO 80524-3960 | 2014-03-04 |
| 1043633324 | Benjamin Miceli | Physician Assistant | 1107 S Lemay Ave, Suite 240, Fort Collins, CO 80524-3960 | 2014-01-22 |
| 1851727077 | Erin Trebon | Social Worker | 1107 S Lemay Ave, Ste 200, Fort Collins, CO 80524 | 2013-09-19 |
| 1790044667 | Peggy Ann Schlomer | Registered Nurse | 1107 S Lemay Ave, Ste 240, Fort Collins, CO 80524-3960 | 2012-05-11 |
| 1285924720 | Amber Elizabeth Steves | Family Medicine | 1107 S Lemay Ave, Suite 200, Fort Collins, CO 80524-3960 | 2011-04-18 |
| 1902100571 | Poudre Valley Medical Group, LLC | Neurological Surgery | 1107 S Lemay Ave, Suite 240, Fort Collins, CO 80524-3959 | 2010-12-22 |
| 1336441013 | Roxanne Merle Slayden | Physician Assistant | 1107 S Lemay Ave, Suite 300, Fort Collins, CO 80524-3955 | 2010-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669084612 | Summitstone Health Partners | Clinic/Center | 1008 Patton St., Fort Collins, CO 80524 | 2020-08-20 |
| 1396355244 | Kidstuff Child and Family Counseling, P.C. | Psychologist | 1006 Robertson St., Ste. 120, Fort Collins, CO 80524 | 2020-08-05 |
| 1215561857 | Transform The Nest LLC | Social Worker | 405 A Matthews Street, Fort Collins, CO 80524 | 2020-02-22 |
| 1326671413 | Laura Ann Doyle | Registered Nurse | 8775 County Road 80.5 # 5, Fort Collins, CO 80524 | 2020-02-17 |
| 1013496835 | Stepheny Nicol Chapple | Psychologist | 701 S College Drive, 201, Fort Collins, CO 80524 | 2018-08-13 |
| 1609372432 | Tracy Jo Close | Counselor | 1031 Robinson Street, Fort Collins, CO 80524 | 2018-04-02 |
| 1831617828 | Rachel Elizabeth Brenner | Counselor | 151 W Lake Rd, Csu Health Network Counseling Services, Fort Collins, CO 80524 | 2017-08-30 |
| 1205366820 | Victoria Marie Sechser | Specialist/Technologist | 1102 Peterson St, Fort Collins, MN 80524 | 2017-06-15 |
| 1013367705 | Smith Street LLC | Day Training, Developmentally Disabled Services | 308 Smith St., Fort Collins, CO 80524 | 2016-06-14 |
| 1811344989 | Ignite Speech-language Services | Clinic/Center | 3921 Celtic Lane, Fort Collins, CO 80524 | 2016-05-18 |
| Find all providers in zip 80524 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386244895 | Cheyenne M Zurfluh | Physician Assistant | 1301 Lory St, Fort Collins, CO 80524-4213 | 2020-10-26 |
| 1790382240 | Katherine Kowalk | Physician Assistant | 3108 Bryce Dr, Fort Collins, CO 80525-3119 | 2020-10-07 |
| 1295384766 | Katelyn Feczko | Physician Assistant | 1120 E Elizabeth St Ste 2, Fort Collins, CO 80524-4044 | 2019-09-08 |
| 1750936506 | Stefan Lee | Physician Assistant | 2813 Seccomb St, Fort Collins, CO 80526-6211 | 2019-08-08 |
| 1801372065 | Rachael Mcgaha Miller | Physician Assistant | 837 Columbia Rd, Fort Collins, CO 80525-1837 | 2018-07-11 |
| 1699287953 | Caroline Kelly Tuchowski | Physician Assistant | 2121 E Harmony Rd Unit 360, Fort Collins, CO 80528-3404 | 2017-10-26 |
| 1639543473 | Mh Health Care Services, PC | Physician Assistant | 2310 E Prospect Rd Ste D, C/o Larimer County Employee Health Center, Fort Collins, CO 80525-9770 | 2015-11-17 |
| 1851783435 | Christon Chilen | Physician Assistant | 2950 Brumbaugh Dr, Fort Collins, CO 80526-6231 | 2015-02-19 |
| 1851797104 | Julianna Valdez Taylor | Physician Assistant | 214 N Howes St, Fort Collins, CO 80521-2011 | 2014-11-14 |
| 1356778914 | Reed Mark Soukup | Physician Assistant | 2001 S Shields E101, Fort Collins, CO 80526-1872 | 2013-09-27 |
| Find all providers in FORT COLLINS | ||||
| City | FORT COLLINS |
| Zip Code | 80524 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.