MEDICARE: MR. TROY GAVIN FREEDMAN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	2868	CO
2	363AM0700X	Medical Physician Assistant	PA.0002868	CO

General Provider Information

NPI Number	:	1194033902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TROY GAVIN FREEDMAN PA-C

Provider Business Mailing Address
First Line	:	32214 ELLINGWOOD TRL STE 210
Second Line	:
City	:	EVERGREEN
State	:	CO
Zip	:	80439-9719
Country	:	US
Telephone Number	:	303-679-2020
Fax Number	:	303-670-2160

Provider Business Practice Location Address
First Line	:	32214 ELLINGWOOD TRL
Second Line	:	SUITE 210
City	:	EVERGREEN
State	:	CO
Zip	:	80439-9779
Country	:	US
Telephone Number	:	303-679-2020
Fax Number	:	303-670-2160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2010
Last Update Date	:	02/09/2026

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