Individual provider Active NPI

Angela Lisovsky

  • Student in an Organized Health Care Education/Training Program
  • Lone Tree, CO
National Provider Identifier
1073369153
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
10099 Ridgegate Pkwy Ste 200
Lone Tree, CO 80124-5532
Phone
(303) 263-8791
NPI assigned
Apr 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CO Primary

Addresses

Primary practice location

10099 Ridgegate Pkwy Ste 200
Lone Tree, CO 80124-5532

Mailing address

10099 Ridgegate Pkwy Ste 200
Lone Tree, CO 80124-5532

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260611003145 CO Order and Referring Only - General SurgeryPractitioner - General Surgery 9436621364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1073369153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10099 RIDGEGATE PKWY STE 200",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10099 RIDGEGATE PKWY STE 200",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245532",
            "telephone_number": "303-263-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISOVSKY",
        "first_name": "ANGELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-29",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

Verify at the official NPI Registry.