Individual provider Active NPI

Kyle Sanders, PT

  • Physical Therapist
  • Pueblo, CO
National Provider Identifier
1124495163
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3676 Parker Blvd
Suite 370
Pueblo, CO 81008-2212
Phone
(719) 553-2209
Fax
(719) 553-2219
NPI assigned
Aug 25, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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 Primary

Addresses

Primary practice location

3676 Parker Blvd
Suite 370
Pueblo, CO 81008-2212

Mailing address

4110 Briargate Pkwy
Ste 300
Colorado Springs, CO 80920-7837
Phone (719) 553-2209

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160804000392 CO Practitioner - Physical Therapist in Private Practice 2961796545 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)

1411 S Potomac St
350 Coc Arapahoe Sports Medicine and Rehab
Aurora, CO 80012-4543
Phone (303) 695-6060

145 Inverness Dr E
Englewood, CO 80112-5172

2430 Research Pkwy
Colorado Springs, CO 80920-1093

Merit-based Incentive Payment System (MIPS)

Final score
43.24 of 100Reported as group
Quality
73.53
Promoting interoperability
0
Improvement activities
0
Cost
70.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Centers of Colorado, LLC Physical Therapist CurrentSince Sep 1, 2020 Accepting new patients
Orthopedic Centers of Colorado, LLC Physical Therapist CurrentSince Sep 1, 2020 Accepting new patients

Locations

1411 S Potomac St
Ste 350
Aurora, CO 80012
Phone (303) 671-2134

2430 Research Pkwy
Ste 100
Colorado Springs, CO 80920
Phone (719) 623-1050

2430 Research Pkwy
Ste 205
Colorado Springs, CO 80920
Phone (505) 322-6687

1263 Lake Plaza Dr
Ste 210
Colorado Springs, CO 80906
Phone (719) 623-1050

2446 Research Pkwy
Ste 200
Colorado Springs, CO 80920
Phone (719) 623-1050

8101 E Lowry Blvd
Ste 120
Lowry, CO 80230
Phone (303) 806-1998

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.

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1124495163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 BRIARGATE PKWY",
            "address_2": "STE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207837",
            "telephone_number": "719-553-2209",
            "fax_number": "719-553-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD",
            "address_2": "SUITE 370",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082212",
            "telephone_number": "719-553-2209",
            "fax_number": "719-553-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "KYLE",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-25",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.