| Evans Medical Center | |
|
4700 E Iliff Ave Denver CO 80222-6025 | |
| (303) 946-3322 | |
| Not Available |
| Full Name | Evans Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 4700 E Iliff Ave, Denver, Colorado |
| Authorized Official Name and Position | Ramin Vatan (CEO) |
| Authorized Official Contact | 3039463322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evans Medical Center 1780 S Bellaire St Ste 402 Denver CO 80222-4323 Ph: (303) 946-3322 | Evans Medical Center 4700 E Iliff Ave Denver CO 80222-6025 Ph: (303) 946-3322 |
| NPI Number | 1083273049 |
|---|---|
| Provider Enumeration Date | 06/12/2019 |
| Last Update Date | 08/18/2026 |
| Certification Date | 08/18/2026 |
| Medicare PECOS PAC ID | 2062844780 |
|---|---|
| Medicare Enrollment ID | O20191119001751 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083273049 | NPI | - | NPPES |
| 9000176751 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| Provider Name | Sophia H Rosebrook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194005066 PECOS PAC ID: 0749400935 Enrollment ID: I20150205000954 |
| Provider Name | Samir Haddad |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841248234 PECOS PAC ID: 2860380086 Enrollment ID: I20231212001907 |
| Provider Name | Carrie Delany Busch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780448688 PECOS PAC ID: 7517301153 Enrollment ID: I20240222000331 |
| Provider Name | Jennifer Anne Cammilleri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194193631 PECOS PAC ID: 3173963014 Enrollment ID: I20240425003182 |
| Provider Name | Godfrey Andrew Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235810599 PECOS PAC ID: 4284172933 Enrollment ID: I20240813003818 |
| Provider Name | Danya Leigh Michelle Rowan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528856135 PECOS PAC ID: 4183122039 Enrollment ID: I20250811000087 |
| Provider Name | Amanda Roslyn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801040258 PECOS PAC ID: 7416970199 Enrollment ID: I20250917002562 |
| Provider Name | Nichole Maier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205722022 PECOS PAC ID: 5395241624 Enrollment ID: I20251003003966 |
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