NPIMap

Individual provider Active NPI

Kelly Elizabeth Bianchi, PA

  • Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1194345165
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0009749 Issued in CO
Practice address
1024 S Lemay Ave
Fort Collins, CO 80524-3929
Phone
(970) 484-4757
Fax
(970) 484-4759
NPI assigned
Apr 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0009749 CO Primary

Addresses

Primary practice location

1024 S Lemay Ave
Fort Collins, CO 80524-3929

Mailing address

2008 Caribou Dr
Fort Collins, CO 80525-4325
Phone (970) 484-4757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210128003012 MA Practitioner - Physician Assistant 6507270766 Reassigns benefits to 4 organizations
I20260505000962 CO Practitioner - Physician Assistant 6507270766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Collins Radiologic Associates PCGroup PAC ID 7315844396, 63 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0009749COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan of Massachusetts - Fall River Inc Physician Assistant CurrentSince Dec 31, 2025 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Apr 15, 2021 Accepting new patients
Lifespan of Massachusetts - Fall River Inc CurrentSince Dec 31, 2025 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

795 Middle St
Fall River, MA 02721
Phone (508) 235-5046

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

Interoperability endpoints

  • Direct secure messaging: kelly.bianchi@935456183615492.direct.elationemr.com
  • Direct secure messaging: kbianchi@trhawc-ma.direct.office.nextgen.com

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.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1194345165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 CARIBOU DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254325",
            "telephone_number": "970-484-4757",
            "fax_number": "970-484-4759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 S LEMAY AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243929",
            "telephone_number": "970-484-4757",
            "fax_number": "970-484-4759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIANCHI",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-20",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0009749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.