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Individual provider Active NPI

Allison Marie Mitas, FNP

  • Family Nurse Practitioner
  • Lafayette, CO
National Provider Identifier
1013220565
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
64 Issued in CO
Practice address
280 Exempla Cir
Lafayette, CO 80026-3370
Phone
(303) 338-4545
NPI assigned
Jul 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5004792 NC
Family Nurse Practitioner 363LF0000X 64 CO Primary

Addresses

Primary practice location

280 Exempla Cir
Lafayette, CO 80026-3370

Mailing address

280 Exempla Cir
Lafayette, CO 80026-3370
Phone (303) 338-4545

Other identifiers 2

IdentifierTypeStateIssuer
024331OtherCOKAISER COMMERCIAL NUMBER
28506049MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131029001727 CO Practitioner - Nurse Practitioner 8123142858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Longs Peak Family Practice, PCGroup PAC ID 8527036128, 7 clinicians

Practice addresses (Care Compare)

1309 Sunset St
Longmont, CO 80501-3215
Phone (303) 772-5578

Hospital & facility affiliations

  • Boulder Community Health Hospital, Boulder, CO, CCN 060027
  • Longs Peak Hospital Hospital, Longmont, CO, CCN 060128
  • Longmont United Hospital Hospital, Longmont, CO, CCN 060003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5004792NCMDFamily Nurse Practitioner
64COMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Portercare Adventist Health System Current Accepting new patients
Portercare Adventist Health System CurrentSince Sep 1, 2013 Accepting new patients
Portercare Adventist Health System CurrentSince Sep 1, 2013 Accepting new patients
Longs Peak Family Practice, PC Family Medicine CurrentSince Feb 13, 2017 Accepting new patients
Raleigh Durham Medical Group PA Family Medicine PastSince Jul 25, 2021 Accepting new patients

Locations

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

1309 Sunset St
Longmont, CO 80501
Phone (303) 772-5578

Organizations & group practices 5

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

Hospital & facility affiliations 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1013220565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 EXEMPLA CIR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263370",
            "telephone_number": "303-338-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 EXEMPLA CIR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263370",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITAS",
        "first_name": "ALLISON",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004792",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "64",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "024331",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28506049",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

Verify at the official NPI Registry.