MEDICARE: MR. THOMAS A MENSHENFRIEND 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	363AS0400X	Surgical Physician Assistant	1488	CO
2	363A00000X	Physician Assistant	PA.0001488	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00204378	OTHER	CO	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	510455703005	OTHER	CO	ROCKY MOUNTAIN HMO

General Provider Information

NPI Number	:	1134186687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS A MENSHENFRIEND PA-C

Provider Business Mailing Address
First Line	:	9949 S OSWEGO ST STE 200
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80134-3753
Country	:	US
Telephone Number	:	303-925-4750
Fax Number	:	303-925-4751

Provider Business Practice Location Address
First Line	:	9949 S OSWEGO ST STE 200
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80134-3753
Country	:	US
Telephone Number	:	303-925-4750
Fax Number	:	303-925-4751

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	09/17/2024

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Directions to “ MR. THOMAS A MENSHENFRIEND PA-C” Practice Location

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