Provider Demographics
NPI:1497901409
Name:ROLINGHER, FREDERICK SHAWN (PA-C)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:SHAWN
Last Name:ROLINGHER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4264 E DICKENSON PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6015
Mailing Address - Country:US
Mailing Address - Phone:720-839-2046
Mailing Address - Fax:303-484-2457
Practice Address - Street 1:7929 W 105TH PL
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-3959
Practice Address - Country:US
Practice Address - Phone:720-839-2046
Practice Address - Fax:303-484-2457
Is Sole Proprietor?:No
Enumeration Date:2008-08-10
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.00026362084P0800X, 2084P0800X
COPA2636363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO63050234Medicaid
WY1497901409Medicaid
COCOA102915Medicare PIN