NPIMap

Individual provider Active NPI

Kiranmayi Padmaja Pires, PA-C

  • Physician Assistant
  • Lakewood, CO
National Provider Identifier
1225646409
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0007939 Issued in CO
Practice address
325 S Teller St Ste 250
Lakewood, CO 80226-7429
Phone
(303) 403-6600
NPI assigned
Jul 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA.0007939 CO Primary

Addresses

Primary practice location

325 S Teller St Ste 250
Lakewood, CO 80226-7429

Mailing address

325 S Teller St
Lakewood, CO 80226-7388
Phone (303) 403-6600

Other practice location 1

12790 W Alameda Pkwy Ste A
Lakewood, CO 80228-2850
Phone (303) 403-6350

Other names 1

  • Kiranmayi Navaneethakrishnan Other 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
I20230801003603 CO Practitioner - Physician Assistant 2668850504 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
Telehealth
Offers telehealth services
Group practices
Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

12790 W Alameda Pkwy a
Green Mountain Clinic Primary Care
Lakewood, CO 80228-2850
Phone (303) 403-6350

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

  • Intermountain Health Lutheran Hospital Hospital, Wheat Ridge, CO, CCN 060009

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Jul 31, 2023 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jul 31, 2023 Accepting new patients
Children'S Healthcare Associates, LLP PastSince Aug 30, 2020 Accepting new patients
Amarillo Primary Care PLLC PastSince Feb 1, 2022 Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

325 S Teller St
Ste 250
Lakewood, CO 80226
Phone (303) 232-8383

12790 W Alameda Pkwy
Ste A
Lakewood, CO 80228
Phone (303) 403-6350

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 5

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": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1225646409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 S TELLER ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802267388",
            "telephone_number": "303-403-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 S TELLER ST STE 250",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802267429",
            "telephone_number": "303-403-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12790 W Alameda Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802282850",
            "country_code": "US",
            "telephone_number": "303-403-6350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIRES",
        "first_name": "KIRANMAYI",
        "middle_name": "PADMAJA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRANMAYI",
            "last_name": "NAVANEETHAKRISHNAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.