Individual provider Active NPI

Kristen C Roessler, M.D.

  • Pediatrics Physician
  • Durango, CO
National Provider Identifier
1083656151
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
42426 Issued in CO
Practice address
281 Sawyer Dr Ste 100
Durango, CO 81303-3409
Phone
(970) 259-2162
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 42426 CO Primary

Addresses

Primary practice location

281 Sawyer Dr Ste 100
Durango, CO 81303-3409

Mailing address

281 Sawyer Dr Ste 100
Durango, CO 81303-3409
Phone (970) 259-2162

Other identifiers 3

IdentifierTypeStateIssuer
02597280MedicaidNY
1613555553OtherBUSINESS TAX ID
11775548MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX2 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
I20120214000581 CO Practitioner - Pediatric MedicinePractitioner - Pain Management 3173781572 Reassigns benefits to 1 organization
I20200730003066 TX Practitioner - Pediatric Medicine 3173781572 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42426COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Pagosa Medical Group LLC CurrentSince Jun 1, 2018 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Jul 24, 2020 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Jul 24, 2020 Accepting new patients

Locations

27B Talisman Dr
Unit 3
Pagosa Springs, CO 81147
Phone (970) 372-0456

Interoperability endpoints

  • Direct secure messaging: kristen.roessler@66979158884356.direct.elationemr.com

Organizations & group practices 3

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1083656151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 SAWYER DR STE 100",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813033409",
            "telephone_number": "970-259-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 SAWYER DR STE 100",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813033409",
            "telephone_number": "970-259-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESSLER",
        "first_name": "KRISTEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "42426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02597280",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS TAX ID",
            "identifier": "1613555553",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11775548",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.