Active NPI
Mitchell Brent Liester, M.D.
- Psychiatry Physician
- Monument, CO
National Provider Identifier
1366430605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 29395
- Practice address
- 153 Washington St
Suite 103
Monument, CO 80132-9181 - Phone
- (719) 488-0024
- Fax
- (719) 488-6672
- NPI assigned
- Oct 11, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 29395 | CO | Primary |
Addresses
Primary practice location
153 Washington St
Suite 103
Monument, CO 80132-9181
Mailing address
PO Box 302
Monument, CO 80132-0302
Phone (719) 488-0024
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01293950 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071112000528 | CO | Practitioner - Psychiatry | 2264520055 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of Colorado School of Medicine, Denver, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
153 N Washington St
Suite 103
Monument, CO 80132-9181
Phone (719) 488-0024
Hospital & facility affiliations
- Uch-Memorial Health System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29395 | CO | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mitchell B. Liester, M.D., P.C. | Current | Accepting new patients |
Locations
153 Washington St
Monument, CO 80132
Phone (719) 488-0402
153 Washington St
Unit 103
Monument, CO 80132
Phone (719) 488-0024
Interoperability endpoints
- mitchell.liester.1@17631.direct.athenahealth.com
Organizations & group practices 1
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 18
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": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357603200000",
"number": "1366430605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 302",
"city": "MONUMENT",
"state": "CO",
"postal_code": "801320302",
"telephone_number": "719-488-0024",
"fax_number": "719-488-6672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "153 WASHINGTON ST",
"address_2": "SUITE 103",
"city": "MONUMENT",
"state": "CO",
"postal_code": "801329181",
"telephone_number": "719-488-0024",
"fax_number": "719-488-6672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIESTER",
"first_name": "MITCHELL",
"middle_name": "BRENT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-11",
"last_updated": "2013-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CO",
"license": "29395",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01293950",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monument, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.
- 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.