Individual provider Active NPI

Kimberlee J Olsen, M.D.

  • Anesthesiology Physician
  • Fort Collins, CO
National Provider Identifier
1083830111
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
DR.0047454 Issued in CO
Practice address
1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000
Phone
(970) 224-2985
Fax
(970) 472-9381
NPI assigned
Apr 17, 2007
Last updated
Jun 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25322 NE
Anesthesiology Physician 207L00000X DR.0047454 CO Primary

Addresses

Primary practice location

1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000

Mailing address

1236 E Elizabeth St
Suite 1
Fort Collins, CO 80524-4000
Phone (970) 224-2985

Other identifiers 2

IdentifierTypeStateIssuer
P00748254OtherCOMEDICARE - RR
02737825MedicaidCO

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
I20090729000970 CO Practitioner - Anesthesiology 8921151556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Nebraska College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Colorado Anesthesia Professionals PLLCGroup PAC ID 6800878760, 155 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Ncap PLLC
Fort Collins, CO 80524-3929
Phone (970) 495-7000

200 Exempla Cir
Ncap PLLC
Lafayette, CO 80026-3370
Phone (303) 689-4000

2500 E Prospect Rd
Ncap PLLC
Fort Collins, CO 80525-9718
Phone (970) 493-0112

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-2985

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25322NEMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Colorado Anesthesia Professionals PLLC Anesthesiology CurrentSince Aug 10, 2009 Accepting new patients

Locations

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

1236 E Elizabeth St
Ste 1
Fort Collins, CO 80524
Phone (970) 236-2628

2500 E Prospect Rd
Fort Collins, CO 80525
Phone (800) 722-7441

3702 Automation Way
Ste 103
Fort Collins, CO 80525
Phone (970) 495-6201

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1083830111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 E ELIZABETH ST",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244000",
            "telephone_number": "970-224-2985",
            "fax_number": "970-472-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 E ELIZABETH ST",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244000",
            "telephone_number": "970-224-2985",
            "fax_number": "970-472-9381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "KIMBERLEE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NE",
            "license": "25322",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "DR.0047454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - RR",
            "identifier": "P00748254",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02737825",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.