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1538459185

NPI Code Detail

MEDICARE: DR. ANNE MARIE PRENDERGAST MD

MEDICARE: DR. ANNE MARIE PRENDERGAST MD

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	207P00000X	Emergency Medicine Physician	0055653	CO
2	207P00000X	Emergency Medicine Physician	47169	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	026518	OTHER	CO	KAISER COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1538459185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE MARIE PRENDERGAST MD

Provider Business Mailing Address
First Line	:	10350 E DAKOTA AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-1314
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10350 E DAKOTA AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-1314
Country	:	US
Telephone Number	:	303-338-4545
Fax Number	:

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

Provider Enumeration Date	:	04/17/2011
Last Update Date	:	01/22/2026

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Directions to “ DR. ANNE MARIE PRENDERGAST MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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