NPIMap

Individual provider Active NPI

Kim Jean Buckley, PA-C

  • Medical Physician Assistant
  • Golden, CO
National Provider Identifier
1144258252
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1535 Issued in CO
Practice address
5920 McIntyre St
Golden, CO 80403-7445
Phone
(303) 949-1250
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1535 CO Primary

Addresses

Primary practice location

5920 McIntyre St
Golden, CO 80403-7445

Mailing address

5920 McIntyre St
Golden, CO 80403-7445
Phone (303) 949-1250

Other identifiers 1

IdentifierTypeStateIssuer
00438715MedicaidCO

Other names 1

  • Kimberly Jean Seibel Former name

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
I20070131000114 CO Practitioner - Physician Assistant 3173524337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meadows Family Medical Center IncGroup PAC ID 0446151617, 64 clinicians

Practice addresses (Care Compare)

999 17TH St
Suite 500
Denver, CO 80202-2728
Phone (720) 355-0539

Hospital & facility affiliations

  • Optimal Home Care Loveland Home health agency, Loveland, CO, CCN 067546
  • Home Health Care Professionals Inc Home health agency, Englewood, CO, CCN 067054
  • Optimal Home Care Inc Home health agency, Denver, CO, CCN 067453
  • Denver Hospice the Hospice, Denver, CO, CCN 061504
  • Berkley Palliative Care and Hospice, LLC Hospice, Aurora, CO, CCN 061594
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1535COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Flatirons Family Practice Inc PastSince Jan 9, 2011 Accepting new patients
Senior Care of Colorado, PC PastSince Sep 1, 2010 Accepting new patients
Inpatient Consultants of Colorado PC Past Accepting new patients
Inpatient Consultants of Colorado, PC Past Accepting new patients

Organizations & group practices 5

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1144258252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 MCINTYRE ST",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804037445",
            "telephone_number": "303-949-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 MCINTYRE ST",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804037445",
            "telephone_number": "303-949-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "KIM",
        "middle_name": "JEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "1535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00438715",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SEIBEL",
            "middle_name": "JEAN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Golden, CO

Sources for this page

Verify at the official NPI Registry.