NPIMap

Organization Active NPI

Klarisana Physician Services PLLC

  • General Practice Physician
  • Denver, CO
National Provider Identifier
1013384866
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
P8449 Issued in TX
Legal business name
KLARISANA PHYSICIAN SERVICES PLLC
Practice address
1240 S Parker Rd Ste 100
Denver, CO 80231-2177
Phone
(000) 000-0000
NPI assigned
Aug 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Authorized official

Name
Dr. Carl John Bonnett, M.D.NPI 1427007327
Title
Managing Member
Phone
(303) 945-6054

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X P8449 TX Primary

Addresses

Primary practice location

1240 S Parker Rd Ste 100
Denver, CO 80231-2177

Mailing address

8670 Wolff CT # 270
Westminster, CO 80031-6956
Phone (844) 455-2747

Other practice location 1

8600 Wurzbach Rd Ste 1110
San Antonio, TX 78240
Phone (210) 556-1430

Other practice location 2

12174 N Mopac Expy Ste A
Austin, TX 78758-2910
Phone (000) 000-0000

Other names 1

  • Klarisana PLLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170626001558 TX Part B Supplier - Clinic/Group Practice 1759659238 Receives reassigned benefits from 7 practitioners
Practice locations: Austin, TX; San Antonio, TX
O20221213000493 CO Part B Supplier - Clinic/Group Practice 1759659238 Receives reassigned benefits from 22 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Centennial, CO; Denver, CO; Longmont, CO; Thornton, CO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Klarisana Physician Services PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6650 S Vine St
Ste 100
Centennial, CO 80121
Phone (303) 535-7548

9195 Grant St
Ste 130
Thornton, CO 80229
Phone (303) 535-7548

8670 Wolff Ct
#270
Westminster, CO 80031
Phone (303) 972-3634

4005 Spicewood Springs Rd
Ste A200
Austin, TX 78759
Phone (512) 231-9333

8600 Wurzbach Rd
Ste 1110
San Antonio, TX 78240
Phone (210) 556-1430

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1013384866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8670 WOLFF CT # 270",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800316956",
            "telephone_number": "844-455-2747",
            "fax_number": "800-247-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 S PARKER RD STE 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802312177",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8600 Wurzbach Rd Ste 1110",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78240",
            "country_code": "US",
            "telephone_number": "210-556-1430",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12174 N Mopac Expy Ste A",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787582910",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KLARISANA PHYSICIAN SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-27",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "BONNETT",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "303-945-6054",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "P8449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Klarisana PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Klarisana PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.