| Lisa J Thackwell, PA-C | |
|
4190 E Woodmen Rd Ste 100, Colorado Springs, CO 80920-8075 | |
| (719) 632-4455 | |
| (360) 462-5181 |
| Full Name | Lisa J Thackwell |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 20 Years |
| Location | 4190 E Woodmen Rd Ste 100, Colorado Springs, Colorado |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689812257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA22118 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| University Colo Health Memorial Hospital Central | Colorado springs, CO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Alpine Medical Group Colorado Pllc | 1759743347 | 101 |
| Matthews-vu Medical Group, P.c. | 3072790864 | 39 |
| Entity Name | Matthews-vu Medical Group, P.C. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649438433 PECOS PAC ID: 3072790864 Enrollment ID: O20110603000138 |
| Entity Name | Alpine Medical Group Colorado PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104501873 PECOS PAC ID: 1759743347 Enrollment ID: O20230814002966 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa J Thackwell, PA-C 960 E Green St, Suite 292, Pasadena, CA 91106-2412 Ph: (626) 449-4494 | Lisa J Thackwell, PA-C 4190 E Woodmen Rd Ste 100, Colorado Springs, CO 80920-8075 Ph: (719) 632-4455 |
Mrs. Lauren Elizabeth Spain, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 175 S Union Blvd Ste 125, Colorado Springs, CO 80910 Phone: 719-365-1950 Fax: 719-365-1951 |
Ms. Kirsten Felice Harlow, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 175 S Union Blvd Ste 125, Colorado Springs, CO 80910 Phone: 719-365-1950 Fax: 719-365-1951 |
Miss Jamie Elizabeth Brady, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 525 Bob Peters Grv Ste 302, Colorado Springs, CO 80909 Phone: 719-365-5445 Fax: 719-365-5530 |
Varinia Vigueras, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4110 Briargate Pkwy Ste 460, Colorado Springs, CO 80920 Phone: 719-364-6488 |
Vi T Pham, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 722 S Wahsatch Ave, Colorado Springs, CO 80903 Phone: 719-632-5700 |
Caleb Seth Smith, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 175 S Union Blvd, Colorado Springs, CO 80910 Phone: 337-550-9939 |
Emily Lynn Rauchut, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6031 E Woodmen Rd Ste 300, Colorado Springs, CO 80923 Phone: 719-521-3391 |