Provider Demographics
NPI:1811975915
Name:MCCLEERY, MICHAEL E (PA)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:E
Last Name:MCCLEERY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:9195 GRANT ST STE 205
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4386
Mailing Address - Country:US
Mailing Address - Phone:720-307-7246
Mailing Address - Fax:720-502-5271
Practice Address - Street 1:799 E HAMPDEN AVE STE 305
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2766
Practice Address - Country:US
Practice Address - Phone:720-307-7246
Practice Address - Fax:720-502-5271
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO1678363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO65203232Medicaid
COP82379Medicare UPIN
COC804559Medicare PIN