Individual provider Active NPI

Jessica Bandelier, DPT

  • Physical Therapist
  • Littleton, CO
National Provider Identifier
1093197592
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL0013528 Issued in CO
Practice address
8 W Dry Creek Cir Ste 130
Littleton, CO 80120-4477
Phone
(303) 955-8163
Fax
(720) 387-7244
NPI assigned
Jun 22, 2015
Last updated
Nov 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL0013528 CO Primary

Addresses

Primary practice location

8 W Dry Creek Cir Ste 130
Littleton, CO 80120-4477

Mailing address

PO Box 5718
Kalispell, MT 59903-5718
Phone (406) 756-0134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150918000633 CO Practitioner - Physical Therapist in Private Practice 8123335486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4251 Kipling St
Unit 405
Wheat Ridge, CO 80033-6833
Phone (303) 932-2030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL0013528COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Cognitive and Linguistic Center Inc CurrentSince Jul 20, 2020 Accepting new patients
Uchealth Community Services Physical Therapist CurrentSince Dec 13, 2021 Accepting new patients
Uchealth Community Services Physical Therapist CurrentSince Dec 13, 2021 Accepting new patients
Poudre Valley Medical Group, LLC Past Accepting new patients

Locations

4404 Barranca Ln
Ste 101
Castle Rock, CO 80104
Phone (720) 733-5260

175 Inverness Dr W
Ste 130
Englewood, CO 80112

175 Inverness Dr W
Ste 100
Greenwood Village, CO 80112
Phone (303) 964-3333

8155 Piney River Ave
Ste 100
Littleton, CO 80125
Phone (303) 265-3370

4251 Kipling St
Unit 405
Wheat Ridge, CO 80033
Phone (303) 932-2030

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1093197592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5718",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599035718",
            "telephone_number": "406-756-0134",
            "fax_number": "406-309-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 W DRY CREEK CIR STE 130",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801204477",
            "telephone_number": "303-955-8163",
            "fax_number": "720-387-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDELIER",
        "first_name": "JESSICA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL0013528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.