NPIMap

Individual provider Active NPI

Lisa Anne Brenner, PH.D.

  • Psychologist
  • Denver, CO
National Provider Identifier
1083680821
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2312 Issued in CO
Practice address
1055 Clermont St
116B
Denver, CO 80220-3808
Phone
(303) 399-8020
Fax
(303) 393-5076
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2312 CO Primary
Rehabilitation Psychologist 103TR0400X 2312 CO

Addresses

Primary practice location

1055 Clermont St
116B
Denver, CO 80220-3808

Mailing address

1055 Clermont St
116B
Denver, CO 80220-3808
Phone (303) 399-8020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170307001580 CO Practitioner - Clinical Psychologist 9638453897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2312COMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince Mar 1, 2017 Accepting new patients
University Physicians Incorporated CurrentSince Mar 1, 2017 Accepting new patients

Locations

12348 E Montview Blvd
Aurora, CO 80045
Phone (303) 724-4824

1635 Aurora Ct
Aurora, CO 80045
Phone (720) 848-1060

12605 E 16th Ave
Ste F784
Aurora, CO 80045

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

1055 Clermont St
#116B
Denver, CO 80220

Dept 1061
Denver, CO 80256

Organizations & group practices 2

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.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1083680821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 CLERMONT ST",
            "address_2": "116B",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802203808",
            "telephone_number": "303-399-8020",
            "fax_number": "303-393-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 CLERMONT ST",
            "address_2": "116B",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802203808",
            "telephone_number": "303-399-8020",
            "fax_number": "303-393-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "2312",
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "CO",
            "license": "2312",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.