Individual provider Active NPI

Kristina Marie Wilson, M.D.

  • Pediatric Orthopaedic Surgery Physician
  • Aurora, CO
National Provider Identifier
1043473614
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
DR.0071776 Issued in CO
Practice address
13123 E 16TH Ave
Aurora, CO 80045-7106
Phone
(720) 777-1234
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X 43469 AZ
Pediatric Sports Medicine Physician 2080S0010X 43653 TN
Pediatric Orthopaedic Surgery Physician 207XP3100X DR.0071776 CO Primary

Addresses

Primary practice location

13123 E 16TH Ave
Aurora, CO 80045-7106

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-3033

Other names 1

  • Kristina M Zayas-Bazan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111004000010 AZ Practitioner - Sports MedicinePractitioner - Orthopedic SurgeryPractitioner - Pediatric Medicine 7618028317 Reassigns benefits to 1 organization
I20230925003542 CO Practitioner - Orthopedic SurgeryPractitioner - Sports MedicinePractitioner - Pediatric Medicine 7618028317 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43653TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated Pediatric Orthopaedic Surgery CurrentSince Aug 15, 2023 Accepting new patients
University Physicians Incorporated CurrentSince Aug 15, 2023 Accepting new patients
University Physicians Incorporated Pediatrics Current Accepting new patients
Children'S Hospital Colorado Current Accepting new patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jul 7, 2011 Accepting new patients
Phoenix Children'S Hospital Hope Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1665 N Avondale Blvd
Avondale, AZ 85392
Phone (602) 933-0005

20325 N 51st Ave
Ste 116
Glendale, AZ 85308
Phone (602) 933-1010

5131 E Southern Ave
Mesa, AZ 85206
Phone (480) 833-5437

1919 E Thomas Rd
Bldg 2108
Phoenix, AZ 85016
Phone (602) 512-8030

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

1920 E Cambridge Ave
Ste 304
Phoenix, AZ 85006
Phone (602) 933-3335

6990 E Shea Blvd
Ste 104
Scottsdale, AZ 85254

860 Potomac Cir
Aurora, CO 80011
Phone (720) 777-0300

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

469 State Highway 7
Broomfield, CO 80023
Phone (720) 478-5000

1830 N Franklin St
Denver, CO 80218
Phone (303) 253-7373

Dept 1061
Denver, CO 80256

1811 Plaza Dr
Highlands Ranch, CO 80129
Phone (720) 478-0108

9395 Crown Crest Blvd
Parker, CO 80138
Phone (303) 269-4000

Interoperability endpoints

  • Direct secure messaging: kwilson274634@direct.childrenscolorado.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1043473614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 E Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850167710",
            "country_code": "US",
            "telephone_number": "602-933-3033",
            "fax_number": "602-933-5245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "AZ",
            "license": "43469",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "TN",
            "license": "43653",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "CO",
            "license": "DR.0071776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "ZAYAS-BAZAN",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.