Provider Demographics
NPI:1609319789
Name:HOSTERT, SARAH J (PA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:HOSTERT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 E ORCHARD RD STE 350
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2550
Mailing Address - Country:US
Mailing Address - Phone:720-598-0805
Mailing Address - Fax:720-606-2905
Practice Address - Street 1:13402 W COAL MINE AVE STE 240A
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-5407
Practice Address - Country:US
Practice Address - Phone:720-598-0805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110005592363A00000X
CO363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO103330140Medicaid