| Dr Kaitlin Dorothy Vellore, MD | |
| 4803 Ward Rd, Wheat Ridge, CO 80033-1902 | |
| (303) 338-4545 | |
| Not Available | 
| Full Name | Dr Kaitlin Dorothy Vellore | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 4803 Ward Rd, Wheat Ridge, Colorado | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1669761995 | NPI | - | NPPES | 
| 026514 | Other | CO | KAISER COMMERCIAL NUMBER | 
| 40783260 | Medicaid | CO | |
| 010552600 | Medicaid | FL | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | ME118499 (Florida) | Secondary | 
| 208000000X | Pediatrics | 0055171 (Colorado) | Primary | 
| Entity Name | Colorado Permanente Medical Group Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1760599724 PECOS PAC ID: 1254238454 Enrollment ID: O20031216000640 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Kaitlin Dorothy Vellore, MD 10350 E Dakota Ave, Denver, CO 80247-1314 Ph: () - | Dr Kaitlin Dorothy Vellore, MD 4803 Ward Rd, Wheat Ridge, CO 80033-1902 Ph: (303) 338-4545 | 
| Dr. Lori M Dirusso, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4803 Ward Rd, Wheat Ridge, CO 80033 Phone: 303-338-4545 | |
| Larissa Ann Applegate, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3555 Lutheran Pkwy, Suite 200, Wheat Ridge, CO 80033 Phone: 720-284-3700 | |
| Dr. Susan M. Fudge-erickson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3555 Lutheran Parkway, Suite 200, Wheat Ridge, CO 80033 Phone: 720-284-3700 Fax: 303-467-0525 | |
| Barbara Elizabeth Barringer, PAC Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3655 Lutheran Pkwy, Suite 300, Wheat Ridge, CO 80033 Phone: 720-284-3700 Fax: 303-467-0525 | |
| Dr. Katya Bograd, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4803 Ward Rd, Wheat Ridge, CO 80033 Phone: 303-338-4545 | |
| Lance J Lazatin, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6055 W 46th Ave, Suite A, Wheat Ridge, CO 80033 Phone: 303-423-8017 Fax: 720-639-6894 | |
| Dr. Cynthia L. Frederick, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3555 Lutheran Parkway, Suite 200, Wheat Ridge, CO 80033 Phone: 720-284-3700 Fax: 303-467-0525 |