Individual
KELLY J BARBATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3455 LUTHERAN PKWY STE 210, WHEAT RIDGE, CO 80033-6040
(303) 403-6580
(303) 403-7347
Mailing address
3455 LUTHERAN PKWY STE 105, WHEAT RIDGE, CO 80033-6028
(303) 665-2603
(303) 665-2605
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0004045
CO
363A00000X
Physician Assistant
085004616
IL
363A00000X
Physician Assistant
10002704A
IN
363AM0700X
Medical Physician Assistant
4748
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001401956
ANTHEM PTAN
IN
05
—
300036360
—
IN
Enumeration date
10/25/2010
Last updated
05/12/2025
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