NPIMap

Individual provider Active NPI

Alexis Nicole Wirth, PA

  • Medical Physician Assistant
  • Brighton, CO
National Provider Identifier
1306524483
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0008009 Issued in CO
Practice address
2801 Purcell St
Brighton, CO 80601-3551
Phone
(303) 558-0515
NPI assigned
Jul 7, 2023
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA.0008009 CO Primary

Addresses

Primary practice location

2801 Purcell St
Brighton, CO 80601-3551

Mailing address

14045 Denver West Cir Apt 1305
Lakewood, CO 80401-3293
Phone (608) 279-3017

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
I20230730000159 CO Practitioner - Physician Assistant 4486015096 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

360 S Teller St
200 Belmar Clinic Primary Care
Lakewood, CO 80226-7384
Phone (303) 403-6600

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.74 of 100Reported as group
Quality
72.92
Promoting interoperability
100
Improvement activities
40
Cost
72.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0008009COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Apr 28, 2025 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Apr 28, 2025 Accepting new patients
Intermountain Medical Group Denver, LLC Past Accepting new patients
Intermountain Medical Group Denver, LLC PastSince Sep 1, 2024 Accepting new patients
Advanced Urgent Care LLC PastSince Sep 10, 2023 Accepting new patients

Locations

360 S Teller St
#200
Lakewood, CO 80226
Phone (303) 403-6600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1306524483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14045 DENVER WEST CIR APT 1305",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013293",
            "telephone_number": "608-279-3017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 PURCELL ST",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806013551",
            "telephone_number": "303-558-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTH",
        "first_name": "ALEXIS",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0008009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, CO

Sources for this page

Verify at the official NPI Registry.