Marillac Clinic, Inc. - Medicare Primary Care in Grand Junction, CO

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Marillac Clinic, Inc. is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Grand Junction, Colorado. The current practice location for Marillac Clinic, Inc. is 526 29 1/2 Rd, Grand Junction, Colorado. For appointments, you can reach them via phone at (970) 200-1600. The mailing address for Marillac Clinic, Inc. is 526 29 1/2 Rd, Grand Junction, Colorado and phone number is (970) 200-1600.

Marillac Clinic, Inc. is licensed to practice in Colorado (license number 18U295). The clinic also participates in the medicare program and its NPI number is 1518239219. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (970) 200-1600.

Contact Information

Marillac Clinic, Inc.
526 29 1/2 Rd
Grand Junction
CO 81504-0000
(970) 200-1600
(970) 692-8301

Map and Direction


Primary Care Clinic Profile

Full NameMarillac Clinic, Inc.
SpecialityClinic/Center
Location526 29 1/2 Rd, Grand Junction, Colorado
Authorized Official Name and PositionLata Ramachandran (EXECUTIVE DIRECTOR)
Authorized Official Contact9702001600
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Marillac Clinic, Inc.
526 29 1/2 Rd
Grand Junction
CO 81504-0000

Ph: (970) 200-1600		Marillac Clinic, Inc.
526 29 1/2 Rd
Grand Junction
CO 81504-0000

Ph: (970) 200-1600

NPI Details:

NPI Number1518239219
Provider Enumeration Date01/27/2012
Last Update Date09/05/2025

Medicare PECOS Information:

Medicare PECOS PAC ID1052634748
Medicare Enrollment IDO20150105001387

Medical Identifiers

Medical identifiers for Marillac Clinic, Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1518239219NPI-NPPES
38402068MedicaidCO
72071362MedicaidCO
90252365MedicaidCO
39400247MedicaidCO
15522865MedicaidCO
27421767MedicaidCO

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) 18U295 (Colorado)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Marillac Clinic, Inc. acts as a billing entity for following providers:
Provider NameJohn W Whiteside
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1679556427
PECOS PAC ID: 8729138250
Enrollment ID: I20090604000136
Provider NameJames R Pasterz
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1598706640
PECOS PAC ID: 4688666183
Enrollment ID: I20100219000701
Provider NameElizabeth Buisker
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1922262450
PECOS PAC ID: 8325174006
Enrollment ID: I20100406000036
Provider NameKathy E Howe
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1700846318
PECOS PAC ID: 1658284856
Enrollment ID: I20101020001038
Provider NameAnna Jensen
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1639189665
PECOS PAC ID: 6800079070
Enrollment ID: I20110324000982
Provider NameApril D Ross
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487960092
PECOS PAC ID: 9830375385
Enrollment ID: I20110517000672
Provider NameMichael T Reeder
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1003175878
PECOS PAC ID: 2466618053
Enrollment ID: I20120726000173
Provider NameColleen Wright
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568756237
PECOS PAC ID: 9638302599
Enrollment ID: I20140429001799
Provider NameErica D Lovett Fournier
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1437220555
PECOS PAC ID: 4789612318
Enrollment ID: I20150428000211
Provider NameStephen R Pyland
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1679710461
PECOS PAC ID: 1052331915
Enrollment ID: I20150521000111
Provider NameRoseanna M Jennings
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801267133
PECOS PAC ID: 9133420425
Enrollment ID: I20151210000328
Provider NameBradley Seago
Provider TypePractitioner - Oral Surgery
Provider IdentifiersNPI Number: 1578884094
PECOS PAC ID: 7719289255
Enrollment ID: I20151230001193
Provider NameThomas J Lavery
Provider TypePractitioner - Oral Surgery
Provider IdentifiersNPI Number: 1265653505
PECOS PAC ID: 1850614553
Enrollment ID: I20160105000383
Provider NameJudd Chamberlain
Provider TypePractitioner - Oral Surgery
Provider IdentifiersNPI Number: 1194953133
PECOS PAC ID: 0648572404
Enrollment ID: I20160111001807
Provider NameKathryn W Hart
Provider TypePractitioner - Oral Surgery
Provider IdentifiersNPI Number: 1871756304
PECOS PAC ID: 2567769177
Enrollment ID: I20160328000120
Provider NameNikos P Hollis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083163612
PECOS PAC ID: 8527348564
Enrollment ID: I20161208000063
Provider NameStephanie Sayers
Provider TypePractitioner - Osteopathic Manipulative Medicine
Provider IdentifiersNPI Number: 1609294982
PECOS PAC ID: 9335367747
Enrollment ID: I20170713000073
Provider NameSherry Ann Woods
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972060002
PECOS PAC ID: 9537492178
Enrollment ID: I20190613000094
Provider NameGretta Thompson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306575170
PECOS PAC ID: 7517300064
Enrollment ID: I20240212002660
Provider NameKaren E Fallon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083444764
PECOS PAC ID: 0941730485
Enrollment ID: I20250212003055
Provider NameM Kathleen Bird
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1073365417
PECOS PAC ID: 4688104037
Enrollment ID: I20250213003847

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.