| Northstar Neurology Of Colorado Springs Pc | |
|
3920 N Union Blvd Ste 150 Colorado Springs CO 80907-1907 | |
| (719) 694-3595 | |
| (719) 493-9936 |
| Full Name | Northstar Neurology Of Colorado Springs Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3920 N Union Blvd Ste 150, Colorado Springs, Colorado |
| Authorized Official Name and Position | Aparna Komatineni (MD) |
| Authorized Official Contact | 7196943595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northstar Neurology Of Colorado Springs Pc Po Box 38670 Colorado Springs CO 80937-8670 Ph: (719) 694-3595 | Northstar Neurology Of Colorado Springs Pc 3920 N Union Blvd Ste 150 Colorado Springs CO 80907-1907 Ph: (719) 694-3595 |
| NPI Number | 1194340414 |
|---|---|
| Provider Enumeration Date | 06/11/2020 |
| Last Update Date | 09/18/2023 |
| Certification Date | 09/18/2023 |
| Medicare PECOS PAC ID | 5698185817 |
|---|---|
| Medicare Enrollment ID | O20201029000925 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194340414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Aparna Komatineni |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992826424 PECOS PAC ID: 7618148156 Enrollment ID: I20110914000258 |
| Provider Name | Leandrea Joy Tzitzicas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174070536 PECOS PAC ID: 2567728348 Enrollment ID: I20171110001099 |
| Provider Name | Bethany Michelle Heinrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396477576 PECOS PAC ID: 8921453408 Enrollment ID: I20231018003923 |
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