Abby Lise Bleistein, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

39420 Issued in CO

Practice address

2600 Campus Dr
Suite a
Lafayette, CO 80026-3357

Phone

(303) 673-1900

Fax

(303) 673-1915

NPI assigned

Jan 20, 2006

Last updated

Dec 18, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Aug 15, 2018 through Aug 15, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cherry Creek Family Practice PLLC

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  • NPI 1588758650
  NPD (past)
• Eating Recovery Center, LLC

  • Psychiatric Residential Treatment Facility
  • Denver, CO
  • NPI 1629220702

  Internal Medicine

  NPD (past)
• Kenneth H Weisiger MD PC

  dba Clear Creek Medical Group

  • Pulmonary Disease Physician
  • Lakewood, CO
  • NPI 1780611079

  Internal Medicine

  NPD (past)
• Rocky Mountain Primary Care , PC

  • Family Medicine Physician
  • Westminster, CO
  • NPI 1215981634

  Internal Medicine

  NPD (past)
• Todd Dextradeur MD PC

  • Internal Medicine Physician
  • Thornton, CO
  • NPI 1881864072
  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1235119553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ELDORADO BLVD STE 6250",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800213421",
            "telephone_number": "303-272-0768",
            "fax_number": "303-318-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 CAMPUS DR",
            "address_2": "SUITE A",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263357",
            "telephone_number": "303-673-1900",
            "fax_number": "303-673-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEISTEIN",
        "first_name": "ABBY",
        "middle_name": "LISE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "39420",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "39420",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43753311",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00773004",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Blackfeather
• Daphne Ellyn Blake, RN
• Susan L Blakley, M.D.
• Jennifer Susan Blanchard
• Heather L Blatchley, DPT
• Kelli Blenden, CCC-SLP
• Juliet Conners Blevins, M.S. BCBA
• Travis Scott Blevins, M.S.
• Jessica Jo Blinkinsop, LMT
• Abby N Blom

• Internal Medicine Physician in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.