NPIMap

Individual provider Active NPI

Carly Noel Frances Kibler Baltare, PA

  • Physician Assistant
  • Centennial, CO
National Provider Identifier
1326696006
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0006853 Issued in CO
Practice address
8006 E Arapahoe Rd # 100
Centennial, CO 80112-6814
Phone
(303) 220-9168
NPI assigned
Aug 27, 2019
Last updated
Sep 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA.0006853 CO Primary

Addresses

Primary practice location

8006 E Arapahoe Rd # 100
Centennial, CO 80112-6814

Mailing address

8006 E Arapahoe Rd # 100
Centennial, CO 80112-6814
Phone (303) 220-9168

Other practice location 1

2446 Johnson Pl
Santa Clara, CA 95050-5521
Phone (408) 984-0712

Other names 1

  • Carly Kibler Former 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
I20211228000250 CO Practitioner - Physician Assistant 7315338472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

63 N Quebec St
Denver, CO 80230-7358
Phone (303) 812-4950

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Jun 2, 2025 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jun 2, 2025 Accepting new patients
Intermountain Medical Group Denver, LLC Past Accepting new patients

Locations

63 N Quebec St
Ste 200
Denver, CO 80230
Phone (303) 812-4950

63 N Quebec St
Ste 201
Denver, CO 80230
Phone (303) 248-7897

Organizations & group practices 3

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 4

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": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1326696006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8006 E ARAPAHOE RD # 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801126814",
            "telephone_number": "303-220-9168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8006 E ARAPAHOE RD # 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801126814",
            "telephone_number": "303-220-9168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2446 Johnson Pl",
            "address_purpose": "LOCATION",
            "city": "Santa Clara",
            "state": "CA",
            "postal_code": "950505521",
            "country_code": "US",
            "telephone_number": "408-984-0712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALTARE",
        "first_name": "CARLY",
        "middle_name": "NOEL FRANCES KIBLER",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "KIBLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.