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MRS. MARILYN ANN GANDOLPH PHYSICIAN ASSISTANT
NPI 1154388148
Physician Assistant - Medical in Louisville, CO

Active since April 26, 2006PECOS Enrolled
325 W S BOULDER RD STE 101, LOUISVILLE, CO 80027(720) 519-1596(720) 542-9408 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 17, 2018, Feb 27, 2018 (2 updates tracked since 2018).

About Mrs. Marilyn Ann Gandolph Physician Assistant NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MARILYN ANN GANDOLPH PHYSICIAN ASSISTANT (NPI 1154388148) is an individual medical provider in Louisville, Colorado, licensed in Colorado (3015) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154388148
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMRS. MARILYN ANN GANDOLPHCredential: PHYSICIAN ASSISTANT
Location Address325 W S BOULDER RD STE 101Louisville, CO 80027-1130
Mailing Address325 W S Boulder Rd Ste 101Louisville, CO 80027-1130 · (720) 519-1596 · Fax (720) 542-9408
Phone(720) 519-1596
Fax(720) 542-9408
Sole ProprietorNo
Enumeration DateApril 26, 2006
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1154388148 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CO · 3015
325 W S BOULDER RD STE 101, Louisville, CO 80027
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Marilyn Ann Gandolph Physician Assistant is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marilyn Gandolph's NPI number?

The NPI number for Marilyn Gandolph is 1154388148. It was assigned to this individual provider in the NPPES registry on April 26, 2006.

Where is Marilyn Gandolph located?

Marilyn Gandolph practices at 325 W S Boulder Rd Ste 101, Louisville, CO 80027. The listed phone number is (720) 519-1596.

What is Marilyn Gandolph's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Marilyn Gandolph enrolled in Medicare?

Yes. Marilyn Gandolph is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Marilyn Gandolph was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.