Active NPI
Kirstin Nicole Marolf, PA-C
- Physician Assistant
- Fort Collins, CO
National Provider Identifier
1053519389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 20010
- Practice address
- 1124 E Elizabeth St Ste C
Fort Collins, CO 80524-4051 - Phone
- (970) 484-0798
- NPI assigned
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 20010 | CA | Primary |
Addresses
Primary practice location
1124 E Elizabeth St Ste C
Fort Collins, CO 80524-4051
Mailing address
1124 E Elizabeth St Ste C
Fort Collins, CO 80524-4051
Phone (970) 484-0798
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Oregon Health Sciences University School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12201 Pecos St
Suite 500
Westminster, CO 80234-3995
Phone (303) 457-4497
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3229 | CO | MD | Chiropractor |
| 20010 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westmed Primary Care | Current | Accepting new patients | |
| Intermountain Medical Group Denver, LLC | Current | Accepting new patients | |
| Intermountain Medical Group Denver, LLC | Current | Accepting new patients |
Locations
500 Eldorado Blvd
Ste 6300
Broomfield, CO 80021
Phone (303) 272-0803
8601 Turnpike Dr
Unit 200
Westminster, CO 80031
Phone (303) 428-7449
12201 Pecos St
Ste 500
Westminster, CO 80234
Phone (303) 457-4497
Organizations & group practices 4
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.
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- NPI 1083598874
-
- Hematology & Oncology Physician
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- NPI 1558975953
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335744000000",
"number": "1053519389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1124 E ELIZABETH ST STE C",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805244051",
"telephone_number": "970-484-0798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1124 E ELIZABETH ST STE C",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805244051",
"telephone_number": "970-484-0798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAROLF",
"first_name": "KIRSTIN",
"middle_name": "NICOLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-09",
"last_updated": "2012-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "20010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.