Individual provider Active NPI

Kirsten Daly

  • Physician Assistant
  • Centennial, CO
National Provider Identifier
1114507258
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0007426 Issued in CO
Practice address
13111 E Briarwood Ave Ste 105
Centennial, CO 80112-3925
Phone
(303) 632-3640
Fax
(303) 632-3642
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA.0007426 CO Primary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 0007426 CO

Addresses

Primary practice location

13111 E Briarwood Ave Ste 105
Centennial, CO 80112-3925

Mailing address

13001 E 17TH PL RM E7019
Aurora, CO 80045-2570
Phone (719) 342-3895

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240123000496 CO Practitioner - Physician Assistant 9830541184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Denver Wellness AssociatesGroup PAC ID 3274949730, 50 clinicians

Practice addresses (Care Compare)

400 S Colorado Blvd
Suite 600
Denver, CO 80246-1239
Phone (720) 724-3668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0007426COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geraghty Family Medicine PC Single Specialty CurrentSince Aug 28, 2022 Accepting new patients
Denver Wellness Associates PastSince Dec 5, 2021 Accepting new patients
Denver Wellness Associates PastSince Aug 25, 2024 Accepting new patients
Golden Peaks Family Medicine PC Single Specialty PastSince Aug 28, 2022 Accepting new patients
Denver Wellness Associates Single Specialty PastSince Sep 10, 2023 Accepting new patients

Locations

13111 E Briarwood Ave
Ste 105
Centennial, CO 80112
Phone (303) 632-3640

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1114507258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13001 E 17TH PL RM E7019",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452570",
            "telephone_number": "719-342-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13111 E BRIARWOOD AVE STE 105",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801123925",
            "telephone_number": "303-632-3640",
            "fax_number": "303-632-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALY",
        "first_name": "KIRSTEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007426",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "0007426",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.