Active NPI 1952656738 Individual Practitioner Female Practitioner

Lea D Hedstrom , PA-C

Physician Assistant • Ogden, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Lea Hedstrom, PA-C is a certified Physician Assistant practicing in Ogden, UT. With approximately 14 years of clinical experience since completing medical education in 2012, Lea Hedstrom delivers high-quality medical care to the local community at 4650 HARRISON BLVD.

Lea Hedstrom accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

4650 Harrison Blvd

Ogden, UT 844034303

Telephone 8014753090

Fax 8014753089

Associated Practice Facility / Clinic

🏢 Ogden Clinic Pc Facility NPI 1578550083

Medicare Profile & Education

Medical School

Other

Graduation Year

2012

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Ogden, UT

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

14 Yrs +1.5 yrs vs City Avg

City Avg: 12.5 Yrs

State Avg: 12.1 Yrs

Regional Practice Density

112 Specialists

Practicing in Ogden, UT (1904 Statewide)

Telehealth Adoption Rate

4.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

60.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Hedstrom (14 Years) 14 Yrs

Ogden Specialty Average (12.5 Years) 12.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	147	35	$20.00	$5.25
99213 Established patient office or other outpatient visit, typically 15 minutes	69	67	$133.00	$73.04
17000 Destruction of skin growth	47	45	$125.00	$36.74
11102 Tangential biopsy of single skin lesion	34	34	$195.00	$67.59
11103 Biopsy of related skin growth, each additional growth	26	18	$105.00	$39.67
17110 Destruction of up to 14 skin growths	16	16	$171.00	$75.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	2,200	11	$2.00	$1.63
17003 Destruction of precancer skin growth, 2-14 growths	593	112	$20.00	$5.35
99213 Established patient office or other outpatient visit, typically 15 minutes	275	198	$133.00	$71.84
17000 Destruction of skin growth	181	146	$125.00	$32.55
11102 Tangential biopsy of single skin lesion	151	122	$195.00	$63.72
11103 Biopsy of related skin growth, each additional growth	137	74	$105.00	$40.41
17110 Destruction of up to 14 skin growths	62	57	$171.00	$74.08
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	46	34	$186.00	$75.11
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	41	38	$1799.00	$680.93
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	38	27	$202.00	$93.16
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	35	35	$1655.00	$668.89
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	34	32	$83.00	$45.59
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	30	25	$182.00	$97.83
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	29	21	$883.00	$334.93
11104 Punch biopsy, first skin growth	27	25	$240.00	$91.49
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	23	22	$1742.00	$861.65
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	17	16	$191.00	$87.48
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	15	15	$1760.00	$752.53
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	14	11	$679.00	$280.69
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	13	13	$1860.00	$709.56
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	11	11	$165.00	$110.28

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	715	130	$20.00	$5.44
99213 Established patient office or other outpatient visit, typically 15 minutes	254	206	$127.26	$73.72
17000 Destruction of skin growth	214	164	$125.00	$35.07
11102 Tangential biopsy of single skin lesion	168	137	$195.00	$66.15
11103 Biopsy of related skin growth, each additional growth	122	64	$105.00	$41.42
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	98	86	$177.56	$103.48
17110 Destruction of up to 14 skin growths	80	64	$171.00	$73.19
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	54	36	$186.00	$75.80
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	40	38	$77.50	$45.86
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	39	36	$1799.00	$688.66
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	34	32	$1655.00	$679.87
11104 Punch biopsy, first skin growth	30	30	$240.00	$99.76
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	30	29	$1742.00	$883.20
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	26	26	$883.00	$356.55
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	22	20	$202.00	$105.18
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	19	18	$165.00	$94.18
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	18	18	$1860.00	$737.79
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	14	13	$191.00	$97.19
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	13	13	$1760.00	$745.64
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	13	13	$679.00	$335.09
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	13	13	$207.00	$110.69
13133 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less	12	11	$254.00	$137.29
17004 Destruction of precancer skin growth, 15 or more growths	12	11	$297.00	$135.99
15240 Relocation of patient skin to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet (20 sq centimeters or less)	11	11	$1369.00	$686.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	704	125	$20.00	$5.26
99213 Established patient office or other outpatient visit, typically 15 minutes	280	209	$102.00	$73.88
17000 Destruction of skin growth	206	161	$125.00	$36.63
11102 Tangential biopsy of single skin lesion	139	117	$195.00	$72.68
17110 Destruction of up to 14 skin growths	83	72	$171.00	$81.12
11103 Biopsy of related skin growth, each additional growth	73	43	$105.00	$43.02
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	43	38	$153.00	$103.62
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	42	41	$63.00	$44.84
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	41	39	$1799.00	$709.26
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	39	39	$883.00	$349.27
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	26	26	$1742.00	$891.21
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	25	21	$186.00	$81.28
11104 Punch biopsy, first skin growth	21	21	$240.00	$96.94
17004 Destruction of precancer skin growth, 15 or more growths	21	13	$297.00	$135.02
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	21	20	$1655.00	$707.40
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	19	16	$202.00	$113.02
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	16	16	$679.00	$333.89
13133 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less	16	15	$254.00	$141.44
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	16	16	$1860.00	$813.25
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	11	11	$1760.00	$817.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	648	131	$20.00	$4.89
99213 Established patient office or other outpatient visit, typically 15 minutes	202	170	$102.00	$61.84
17000 Destruction of skin growth	195	161	$125.00	$38.20
11102 Tangential biopsy of single skin lesion	137	120	$195.00	$67.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	91	80	$153.00	$89.44
17110 Destruction of up to 14 skin growths	80	75	$171.00	$79.36
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	67	61	$63.00	$36.01
11103 Biopsy of related skin growth, each additional growth	67	41	$105.00	$42.89
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	45	16	$14.00	$1.45
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	37	36	$883.00	$372.88
11104 Punch biopsy, first skin growth	26	25	$240.00	$98.79
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	26	25	$1799.00	$754.55
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	22	21	$679.00	$325.33
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	19	17	$186.00	$86.65
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	18	17	$1742.00	$902.99
11900 Injection into skin growth, 1-7 growths	16	13	$85.00	$28.37
11105 Punch biopsy, each additional skin growth	16	12	$120.00	$49.55
69100 Biopsy of ear	16	14	$164.00	$48.02
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	14	14	$1860.00	$796.02
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	13	11	$202.00	$106.75
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	13	13	$609.00	$313.25
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	12	12	$1655.00	$687.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	760	165	$20.00	$4.68
99213 Established patient office or other outpatient visit, typically 15 minutes	274	217	$102.00	$61.49
17000 Destruction of skin growth	247	196	$125.00	$36.04
11102 Tangential biopsy of single skin lesion	196	162	$195.00	$65.77
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	125	111	$153.00	$90.38
11103 Biopsy of related skin growth, each additional growth	114	63	$105.00	$43.77
17110 Destruction of up to 14 skin growths	102	84	$171.00	$82.88
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	68	13	$14.00	$1.64
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	61	57	$63.00	$37.18
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	38	38	$679.00	$346.50
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	36	35	$883.00	$383.94
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	33	29	$186.00	$82.37
11104 Punch biopsy, first skin growth	30	30	$240.00	$101.91
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	24	22	$1742.00	$864.26
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	19	16	$190.00	$111.43
69100 Biopsy of ear	18	16	$164.00	$67.74
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	17	16	$854.00	$425.71
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	17	17	$1799.00	$789.62
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	17	16	$1655.00	$731.22
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	17	15	$201.53	$108.91
11105 Punch biopsy, each additional skin growth	17	14	$120.00	$50.17
87070 Bacterial culture	16	16	$28.00	$8.92
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	15	15	$1860.00	$783.95
17004 Destruction of precancer skin growth, 15 or more growths	15	12	$297.00	$125.89
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$154.00	$90.40
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	11	11	$609.00	$317.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,022	177	$20.00	$4.36
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	331	253	$153.00	$89.08
17000 Destruction of skin growth	285	223	$125.00	$35.15
11100 Biopsy of single growth of skin and/or tissue	262	201	$162.00	$72.22
11101 Biopsy of each additional growth of skin and/or tissue	180	96	$52.00	$27.29
99213 Established patient office or other outpatient visit, typically 15 minutes	116	102	$102.00	$60.29
17110 Destruction of up to 14 skin growths	79	73	$171.00	$81.84
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	60	17	$14.00	$1.80
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	46	46	$1742.00	$883.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	40	40	$154.00	$88.24
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	38	37	$883.00	$368.12
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	37	33	$186.00	$86.52
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	31	31	$1799.00	$772.67
69100 Biopsy of ear	30	28	$164.00	$55.13
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	29	27	$679.00	$336.98
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	25	24	$63.00	$36.01
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	23	23	$1655.00	$668.83
17004 Destruction of precancer skin growth, 15 or more growths	22	18	$297.00	$119.46
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	20	17	$200.00	$107.40
14302 Repair of wound by transferring skin, each additional 30.0 sq cm	19	17	$473.00	$190.70
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	19	19	$1860.00	$844.85
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	16	15	$609.00	$277.45
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	14	14	$854.00	$345.70
11900 Injection into skin growth, 1-7 growths	14	13	$85.00	$33.10
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	14	13	$191.00	$85.83
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	13	13	$1760.00	$778.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,088	153	$20.00	$4.61
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	304	234	$153.00	$88.49
11100 Biopsy of single growth of skin and/or tissue	255	202	$160.60	$74.35
17000 Destruction of skin growth	229	175	$120.05	$34.27
11101 Biopsy of each additional growth of skin and/or tissue	219	110	$52.00	$27.20
99213 Established patient office or other outpatient visit, typically 15 minutes	96	90	$102.00	$60.07
17110 Destruction of up to 14 skin growths	68	63	$163.88	$82.37
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	67	14	$14.00	$1.79
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	48	45	$1742.00	$873.01
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	38	38	$883.00	$355.52
17004 Destruction of precancer skin growth, 15 or more growths	37	30	$297.00	$122.84
69100 Biopsy of ear	31	24	$164.00	$51.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	30	30	$154.00	$89.12
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	29	28	$1799.00	$724.66
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	26	21	$174.92	$79.29
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	22	22	$1860.00	$841.75
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	21	20	$63.00	$35.52
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	21	18	$200.00	$107.33
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	20	20	$675.40	$315.15
14302 Repair of wound by transferring skin, each additional 30.0 sq cm	18	16	$473.00	$190.90
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	16	16	$594.00	$323.82

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License UT 8361980-1206

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners

Dr. Chad Tingey , MD

Dermatology

NPI 1043335300

Doctor of Medicine (M.D.)

Jessica Meents , PA-C

Physician Assistant

NPI 1073948196

Physician Assistant (Certified)

Nancy Shina , NP-C

Nurse Practitioner

NPI 1255884037

Nurse Practitioner (Certified)

Gregory Reeves , PA-C

Physician Assistant

NPI 1396184487

Physician Assistant (Certified)

Rebecca Dunn , PA-C

Physician Assistant

NPI 1659509974

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

✅

NPI Profile Active January 17, 2017

NPI status registered as active in NPPES database

📍

Updated Business Mailing Address January 17, 2017

Registered at PO BOX 5546, DENVER, CO 802175546 (Tel: 8014753090)

📍

Updated Practice Location January 17, 2017

Registered at 4650 HARRISON BLVD, OGDEN, UT 844034303 (Tel: 8014753090)

👤

Provider Name / Credentials Updated January 17, 2017

Recorded as LEA HEDSTROM, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 17, 2017

Physician Assistant (License #8361980-1206 in UT)

✅

NPI Profile Active July 05, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location July 05, 2016

Registered at 4650 HARRISON BLVD, OGDEN, UT 844034303 (Tel: 8014753090)

📍

Updated Business Mailing Address July 05, 2016

Registered at 4650 HARRISON BLVD, OGDEN, UT 844034303 (Tel: 8014753000)

👤

Provider Name / Credentials Updated July 05, 2016

Recorded as LEA HEDSTROM, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 05, 2016

Physician Assistant (License #8361980-1206 in UT)

🟢

Initial NPI Registration & Enumeration July 18, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1952656738

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 18, 2012

Last Update: January 17, 2017

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 5546

Denver, CO 802175546

Phone: 8014753090

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.