Individual provider Active NPI

Alexander Otis Kisor

  • Clinical Social Worker
  • Denver, CO
National Provider Identifier
1205435336
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09926977 Issued in CO
Practice address
55 Madison St Ste 240
Denver, CO 80206-5451
Phone
(970) 310-3406
NPI assigned
Oct 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW.09926977 CO Primary

Addresses

Primary practice location

55 Madison St Ste 240
Denver, CO 80206-5451

Mailing address

116 Inverness Dr E Ste 105
Englewood, CO 80112-5125
Phone (303) 730-8858

Other practice location 1

5554 S Prince St
Littleton, CO 80120-1149
Phone (303) 730-8858

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201105000370 CO Practitioner - Clinical Social Worker 4486064326 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart Centered Counseling PCGroup PAC ID 8628373651, 296 clinicians

Practice addresses (Care Compare)

1770 25TH Ave
Suite 206
Greeley, CO 80634-4949
Phone (970) 310-3406

55 Madison St
Suite 240
Denver, CO 80206-5451
Phone (970) 310-3406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arapahoe Mental Health Center, Inc CurrentSince Oct 20, 2020 Accepting new patients
Arapahoe Mental Health Center, Inc Current Accepting new patients
Heart Centered Counseling, PC Clinical CurrentSince Feb 10, 2021 Accepting new patients
Heart Centered Counseling, PC Clinical Current Accepting new patients
Heart Centered Counseling, PC Clinical CurrentSince Feb 10, 2021 Accepting new patients
Arapahoe Mental Health Center, Inc CurrentSince Oct 20, 2020 Accepting new patients

Locations

55 Madison St
Ste 240
Denver, CO 80206
Phone (720) 574-9391

116 Inverness Dr E
Ste 105
Englewood, CO 80112

1770 25th Ave
Ste 206
Greeley, CO 80634
Phone (303) 664-5281

8015 W Alameda Ave
Ste G50
Lakewood, CO 80226
Phone (720) 409-0317

5524 S Prince St
Littleton, CO 80120
Phone (303) 730-0797

5554 S Prince St
Littleton, CO 80120
Phone (720) 427-5707

350 Terry St
Ste 320
Longmont, CO 80501
Phone (303) 746-0342

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": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1205435336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 INVERNESS DR E STE 105",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801125125",
            "telephone_number": "303-730-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MADISON ST STE 240",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802065451",
            "telephone_number": "970-310-3406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5554 S Prince St",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801201149",
            "country_code": "US",
            "telephone_number": "303-730-8858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISOR",
        "first_name": "ALEXANDER",
        "middle_name": "OTIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-20",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09926977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.