Active NPI
Kirstin Bridges
- Physician Assistant
- Indianapolis, IN
National Provider Identifier
1265052856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10003528A
- Practice address
- 1722 Kessler Boulevard East Dr
Indianapolis, IN 46220-2433 - Phone
- (224) 735-9426
- NPI assigned
- Apr 23, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 10003528A | IN | Primary |
Addresses
Primary practice location
1722 Kessler Boulevard East Dr
Indianapolis, IN 46220-2433
Mailing address
1722 Kessler Boulevard East Dr
Indianapolis, IN 46220-2433
Phone (224) 735-9426
Other practice location 1
66 Brentwood Dr
Gilberts, IL 60136-4046
Phone (224) 735-9426
Other practice location 2
325 S Alabama St Ste 100
Indianapolis, IN 46204-3710
Phone (317) 705-4785
Other practice location 3
5210 E Thompson Rd
Indianapolis, IN 46237-2085
Phone (317) 782-7500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Southern Illinois University School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4745 Arapahoe Ave
Boulder, CO 80303-1080
588 N US Hwy 287
Suite 204
Lafayette, CO 80026-2615
Phone (303) 443-2771
90 Health Park Dr
Suite 220
Louisville, CO 80027-9586
Phone (303) 443-2771
Hospital & facility affiliations
- Boulder Community Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10003528A | IN | MD | Physician Assistant |
Organizations & group practices 2
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.
-
- Otolaryngology Physician
- Boulder, CO
- NPI 1194948026
-
- Urgent Care Clinic/Center
- Chicago, IL
- NPI 1205814118
Hospital & facility affiliations 34
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Sleep Disorder Diagnostic Clinic/Center
- Boulder, CO
- NPI 1093357907
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720137600000",
"number": "1265052856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1722 KESSLER BOULEVARD EAST DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462202433",
"telephone_number": "224-735-9426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1722 KESSLER BOULEVARD EAST DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462202433",
"telephone_number": "224-735-9426"
}
],
"practiceLocations": [
{
"address_1": "66 Brentwood Dr",
"address_purpose": "LOCATION",
"city": "Gilberts",
"state": "IL",
"postal_code": "601364046",
"country_code": "US",
"telephone_number": "224-735-9426",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "325 S Alabama St Ste 100",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462043710",
"country_code": "US",
"telephone_number": "317-705-4785",
"fax_number": "317-705-4798",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5210 E Thompson Rd",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462372085",
"country_code": "US",
"telephone_number": "317-782-7500",
"fax_number": "317-782-7515",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRIDGES",
"first_name": "KIRSTIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-23",
"last_updated": "2024-07-05",
"certification_date": "2024-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10003528A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.