Kirsten Deroode, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA0004908 Issued in CO

Practice address

12230 Lioness Way
Parker, CO 80134-5603

Phone

(720) 644-9355

NPI assigned

Jan 26, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Inpatient Consultants of Colorado PC

  • Hospitalist Physician
  • Aurora, CO
  • NPI 1720184690
  Medicare reassignment NPD
• Summit Medical Consultants Aco Prof LLC

  dba Summit Medical Consultants ACO

  • Internal Medicine Physician
  • Greenwood Village, CO
  • NPI 1891471207
  Medicare reassignment
• Summit Medical Consultants PLLC

  • Internal Medicine Physician
  • Greenwood Village, CO
  • NPI 1265822910
  Medicare reassignment
• Portercare Adventist Health System

  dba AdventHealth Medical Group Orthopedics and Spine at Meridian

  • Orthopaedic Surgery Physician
  • Parker, CO
  • NPI 1568071041
  NPD
• Portercare Adventist Health System

  dba AdventHealth Medical Group Urology at Lakewood

  • Urology Physician
  • Lakewood, CO
  • NPI 1942165626
  NPD
• Inpatient Consultants of Colorado, PC

  • Internal Medicine Physician
  • Denver, CO
  • NPI 1538461256

  Hospitalist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1003353178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 E COSTILLA AVE STE 540",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801123648",
            "telephone_number": "720-644-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12230 LIONESS WAY",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801345603",
            "telephone_number": "720-644-9355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11600 W 2nd Pl",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281527",
            "country_code": "US",
            "telephone_number": "720-321-0000",
            "fax_number": "303-306-4337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12605 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452545",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEROODE",
        "first_name": "KIRSTEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-26",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA0004908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eden Depriest
• Derry Chiropractic PC
• Matthew Thomas Derry, D.C.
• Devin K Rentz DDS PC (Stonegate Dental Care)
• Heather Elizabeth Devries, RDN, CLC
• Dalanda Diallo

• Medical Physician Assistant in Parker, CO
• Providers in Parker, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.