| Genesis Eldercare Physician Services LLC | |
|
835 Tenderfoot Hill Rd # T Colorado Springs CO 80906 | |
| (410) 543-1957 | |
| (410) 543-2951 |
| Full Name | Genesis Eldercare Physician Services LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 835 Tenderfoot Hill Rd # T, Colorado Springs, Colorado |
| Authorized Official Name and Position | Eric Shapiro (VICE PRESIDENT) |
| Authorized Official Contact | 4108327790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Eldercare Physician Services LLC Po Box 62946 Baltimore MD 21264-2946 Ph: (410) 494-7607 | Genesis Eldercare Physician Services LLC 835 Tenderfoot Hill Rd # T Colorado Springs CO 80906 Ph: (410) 543-1957 |
| NPI Number | 1801215041 |
|---|---|
| Provider Enumeration Date | 04/15/2014 |
| Last Update Date | 08/05/2019 |
| Medicare PECOS PAC ID | 9830002534 |
|---|---|
| Medicare Enrollment ID | O20141007001168 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801215041 | NPI | - | NPPES |
| Provider Name | Constance Suzanne Cerjan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881655314 PECOS PAC ID: 7416987599 Enrollment ID: I20050818000208 |
| Provider Name | Maureen Kelly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518943554 PECOS PAC ID: 0345159034 Enrollment ID: I20070427000442 |
| Provider Name | Jill L Shepherd |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821488214 PECOS PAC ID: 9032435771 Enrollment ID: I20150224000824 |
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