Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tammie N. Brueckner, PA-C

Individual provider Physician Assistant · NPI 1407212376

Tammie N. Brueckner, PA-C is a Physician Assistant in Lakewood, Colorado. Qualified in 2015, 11 years ago. Practices with Diversified Radiology of Colorado Inc, a 93-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and Colorado.

Years since qualifying
11
Licensed in
CA, CO
In the registry since
2016
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1746 Cole Blvd Ste 100
Lakewood, CO 80401-3208
Phone: (303) 914-8800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 200 W Arbor Dr Bldg 300, San Diego, CA 92103-1911 — (800) 926-8273

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA.0009307 (CO)
Physician Assistant Taxonomy 363A00000X · Licence PA57558 (CA)

Record details

NPI number1407212376
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 8, 2016
Last updated in NPPESSeptember 9, 2025
Certification dateSeptember 9, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Diversified Radiology Of Colorado Inc — 93 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Lakewood